Posted by: Thixia | April 26, 2008

Foot Drop Helped by Botulinum

Foot Drop Helped by Botulinum


Botulinum Toxin Type A Helps Multiple Sclerosis Patients With Spastic Foot Drop: Presented at AAN




Botulinum toxin type A injections can decrease spasticity and improve quality of life in multiple sclerosis (MS) patients with spastic foot drop, according to data released here at the American Academy of Neurology (AAN) 60th Annual Meeting.


Anjali Shah, MD, Assistant Professor, Divisions of Physical Medicine and Rehabilitation and Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, and colleagues reported here on April 15 on data from 19 patients whose spastic foot drop was treated with botulinum toxin type A injections.


Nearly 90% of MS patients report the presence of spasticity, and lower-extremity spasticity increases the energy of walking and aggravates fatigue, Dr. Shah pointed out. Oral antispasticity medications can exacerbate fatigue and decrease cognitive functioning.


Botulinum toxin type A injections focally target spasticity, and do not cause fatigue; there are, however, limited data on the use of such injections to specifically treat spastic foot drop due to plantar flexor spasticity in MS patients.


According to the study protocol, 150 units of botulinum toxin type A diluted in 1 cc of preservative-free saline were injected into the medial gastrocnaemius muscle, lateral gastrocnaemius muscle, and soleus muscle.


Electrical stimulation was used to localise the motor points in the target muscles.


Patients underwent 6 to 8 weeks of physical therapy.


Overall, 74.7% of patients have returned for repeat botulinum toxin type A injections.


Patient self-report surveys revealed improved ambulation with less tripping or toe drag, improved driving ability, and less fatigue.


Results document significant improvement in spasticity (P = .1) and emotional quality of life (P = .035).


Dr. Shah cautioned that the study was limited by small sample size and the use of varying physical-therapy programs between subjects.


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