Botulinum toxin helps improve tremor associated with MS

by Bruce Sylvester – Emerging uses of FDA Approved Drugs –

Botulinum toxin treatment appears to improve tremor in the arms and hands of persons with multiple sclerosis (MS), researchers report in the July 3, 2012, print issue of Neurology.

“Our study suggests a new way to approach arm tremor related to MS where there are currently major treatment challenges, and it also sets the framework for larger studies,” said investigator and author Anneke van der Walt, MD, Royal Melbourne Hospital and the University of Melbourne, Melbourne, Australia.

The investigators enrolled 23 subjests with MS. They were treated for 3 months with botulinum toxin type A injections or a saline placebo. Then they crossed over and had the opposite treatment for 3 months.

Before, during and after treatments, the investigators evaluated tremor severity and ability to write and draw. They also did video assessments every 6 weeks for the 6 months of the study.

They reported significant difference in improvements in tremor severity, writing and drawing at 6 weeks and 3 months after botulinum toxin treatment compared with the same period of time after placebo treatment.

For tremor severity, subjects improved an average of 2 points on a 10-point scale, moving from moderate to mild tremor. For writing and drawing, subjects improved by an average of 1 point on a 10-point scale.

Muscle weakness appeared in 42% of subjects after treatment with botulinum toxin compared with 6% after placebo. It was generally mild and disappeared within 2 weeks.