Symptom Management Poster Presentation

P1086 - Botulinum toxin injections in multiple sclerosis versus post-stroke spasticity (ID 1888)

Speakers
  • A. Dinoto
Authors
  • A. Dinoto
  • A. Sartori
  • G. Mazzon
  • P. Polverino
  • M. Cheli
  • M. Morelli
  • F. Pasquin
  • A. Bratina
  • A. Bosco
  • P. Manganotti
Presentation Number
P1086
Presentation Topic
Symptom Management

Abstract

Background

Botulinum toxin (BTX) is an effective and safe treatment for spasticity both in multiple sclerosis (MS) and post-stroke spasticity (PSS).

Objectives

The aim of our single-centre retrospective study was to compare the sites of injection and the dosages of BTX used for the treatment of spasticity in MS and PSS.

Methods

We enrolled 33 patients with MS and 55 patients with PSS that were treated with BTX in our outpatient spasticity clinic. Clinical and demographic data were collected. Total BTX dosage, upper and lower limb dosage, pattern of injected muscles, and their respective dosage were recorded. We performed a statistical analysis to compare BTX treatment dosage in the two conditions and to investigate any predictor of total BTX dosage.

Results

MS patients received a significant lower total BTX dosage compared to PSS (p<0.001): they were treated with lower BTX dosage in the lower limbs (p=0.005), but not in the upper limbs (p=0.30). Patients with MS were rarely injected in the upper limbs. Proximal upper limbs muscles were more frequently injected in MS, while patients with PSS were more frequently treated in distal muscles (fingers). In the lower limbs MS patients were more frequently injected in adductor muscles and rectus femoris while PSS patients were treated in soleus and tibialis posterior. EDSS was the only variable correlated to total BTX dosage (rho=0.399, p=0.021).

Conclusions

In our experience, MS spasticity requires a lower BTX dosage than PSS. This observation could be explained both by a different pattern of muscles affected by spasticity in these two diseases and also by different clinical management (e.g. the need of maintaining a greater residual function in MS, especially in lower limbs).

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