Botox to Treat Multiple Sclerosis Tremors? New MS Treatment Found

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Photomicrograph of a demyelinating MS-Lesion. Image by Marvin101

Decoded Science: Will Botox injections now become standard treatment for tremors related to MS?

Dr. van der Walt: “We are hopeful that Botox treatments could change the way Neurologists treat tremors in MS people.  However, before it can be considered a main stream treatment, the results need to be validated in a larger and long-term study.
There are several questions that need to be answered by doing larger and longer-term studies.  One such a question is whether there are types of tremor in people with MS that respond better to Botox than others. For example, larger studies may find that people with MS tremor that affects the hands and forearms respond better than tremor that also causes shaking at the shoulders.  
We also need to determine what, if any, improvements there are to the quality of life of people with MS when their tremor is treated in this way.

Decoded Science: How often do patients require Botox shots during MS treatments?
Dr. van der Walt: “The Botox injections can be given every 3-4 months, but is appears to sometimes only needed twice per year. From our experience, it seems that every person will require an individual dosing schedule according to his or her needs. This question could potentially be answered by future studies.  The long-term benefits of Botox treatment need to be studied in more detail. Some of the patients in this study have continued to receive Botox injections after the study finished.  In our experience, the benefit of injections do not diminish over time but the side-effects, particularly weakness, become less of a problem as the doses that are injected can be more accurately defined for a particular person. Clearly, this needs to be studied more scientifically.

Decoded Science: Can patients ask their doctors for Botox injections to treat MS symptoms?
Dr. van der Walt: “Although Botox is licensed for use in several neurological conditions including Focal dystonias such as torticollis, blepharospasm and spasticity (stiffness) after Stroke, it is not licensed to be used for tremor in MS. However, patients could discuss being assessed for this treatment with their neurologist who would be best placed to advise on the availability of using the medication “off-label” in their specific region.”

Treating Multiple Sclerosis Tremors with Botulinum Toxin Type A

Dr. Anneke van der Walt ended the interview, with the final comment,  “I would advise patients who are interested in exploring Botox treatment for their tremor to make sure that they are referred to a Movement disorder specialist with both an interest in tremor and expertise in complex Botox injections.”

As this treatment option further develops into the next stages, Dr. Anneke van der Walt’s study may help improve the quality of life for people with multiple sclerosis.

Resources:

Walt, A., et al. A double-blind, randomized, controlled study of botulinum toxin type A in MS-related tremor. (2012). Neurology. Accessed July 3, 2012.

Warrick, P., Dromey, C., Irish, J.C., Durkin, L., Pakiam, A., Lang, A. Botulinum toxin for essential tremor of the voice with multiple anatomical sites of tremor: a crossover design study of unilateral versus bilateral injection. (2000). Laryngoscope. Accessed July 3, 2012.

U.S. National Library of Medicine. Multiple Sclerosis. (2011). Accessed July 3, 2012.

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