Contributions
Abstract: EP1811
Type: ePoster
Abstract Category: Therapy - symptomatic - 33 Treatment of specific symptoms
Introduction: Few data are available on the use of botulinum toxin for spasticity treatment in multiple sclerosis (MS). In a previous study we found that one of the main therapeutic goals was the improvement ok walking, in patients suffering from spasticity of the triceps surae.
Method: This is a pilot observational study, with the aim to assess the benefit of an injection of 200 UI of uncobotulinumtoxin A in MS patients suffering from spasticity du triceps surae which concern patient with MS with EDSS score lower than 6, needing botulinum toxin for focal spasticity of the triceps surae. The last injection, if the patient had previous botulinum treatment must be performed more than 3 months later. Outcome mesure were Goal Attainment Scale, MSWS-12 scale, TUG, and 6mn Walk test and spatiotemporal gait parameters by barometric pist GaitRITE, before, 6 weeks and 3 months after the injection.
This study was approved by the local ethic comity.
Results: We present the result of 22 patients, with a mean age of 48.2 +/-12 years, and a mean EDSS of 4.2 (median 4.7). There was a significant benefit on injected (0.005) and non injected (0.01) step length measured by GaitRITE but not on supports distribution (0.18;0.38) especially at 3 months. It could explain the decrease of gait fatigability and the increase of speed 6mnWT (0.02) although neither TUG nor MSWS-12 were improved at 3 months after injection. 80% of the patient had reached their objective on the GAS. At 6 weeks, spatiotemporal parameters and 6mnWT were not significantly different even though we observed a significant improvement for the GAS, the MSWS-12 score (p=0.015), and the TUG (p=0.003).
Conclusion: it tends to confirm the interest of botulinum toxin A for the treatment of focal spasticity of the triceps surae with a significant improvement of gait especially on speed and also fatigability and endurance. Further studies are needed to confirm the place of botulinum toxin in this indication, but also the modalities of use in term of dosage and interval between injections. The best results on gait parameters are obtained after 3 months that is different than the results on TUG and MSWS-12.
These results support the place of botulinum toxin in the focal spasticity of the triceps surae in MS and are in concordance with the French recommendations about focal spasticity treatment. Botulinum toxin should probably be discussed early in the management of spasticity in MS patients.
Disclosure: nothing to disclose for every authors
Abstract: EP1811
Type: ePoster
Abstract Category: Therapy - symptomatic - 33 Treatment of specific symptoms
Introduction: Few data are available on the use of botulinum toxin for spasticity treatment in multiple sclerosis (MS). In a previous study we found that one of the main therapeutic goals was the improvement ok walking, in patients suffering from spasticity of the triceps surae.
Method: This is a pilot observational study, with the aim to assess the benefit of an injection of 200 UI of uncobotulinumtoxin A in MS patients suffering from spasticity du triceps surae which concern patient with MS with EDSS score lower than 6, needing botulinum toxin for focal spasticity of the triceps surae. The last injection, if the patient had previous botulinum treatment must be performed more than 3 months later. Outcome mesure were Goal Attainment Scale, MSWS-12 scale, TUG, and 6mn Walk test and spatiotemporal gait parameters by barometric pist GaitRITE, before, 6 weeks and 3 months after the injection.
This study was approved by the local ethic comity.
Results: We present the result of 22 patients, with a mean age of 48.2 +/-12 years, and a mean EDSS of 4.2 (median 4.7). There was a significant benefit on injected (0.005) and non injected (0.01) step length measured by GaitRITE but not on supports distribution (0.18;0.38) especially at 3 months. It could explain the decrease of gait fatigability and the increase of speed 6mnWT (0.02) although neither TUG nor MSWS-12 were improved at 3 months after injection. 80% of the patient had reached their objective on the GAS. At 6 weeks, spatiotemporal parameters and 6mnWT were not significantly different even though we observed a significant improvement for the GAS, the MSWS-12 score (p=0.015), and the TUG (p=0.003).
Conclusion: it tends to confirm the interest of botulinum toxin A for the treatment of focal spasticity of the triceps surae with a significant improvement of gait especially on speed and also fatigability and endurance. Further studies are needed to confirm the place of botulinum toxin in this indication, but also the modalities of use in term of dosage and interval between injections. The best results on gait parameters are obtained after 3 months that is different than the results on TUG and MSWS-12.
These results support the place of botulinum toxin in the focal spasticity of the triceps surae in MS and are in concordance with the French recommendations about focal spasticity treatment. Botulinum toxin should probably be discussed early in the management of spasticity in MS patients.
Disclosure: nothing to disclose for every authors