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Treating MS With Botulinum Toxin

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How Are Botulinum Toxin Treatments Given?

Botulinum toxin is administered as an intramuscular injection (into the muscle). Your doctor will determine which muscles need to be injected to reduce the degree of spasticity.

If the muscles to be injected are small or difficult to reach, it may be necessary to record electric signals from the muscles, to ensure that the appropriate muscles are receiving the injected medication.

A very fine needle is used for the injection. Although the medication usually does not sting or cause irritation, some people report minor and temporary discomfort from the injection.

The effect of the medication begins to appear from one to two weeks after the injection. The muscles injected should start to relax.

What Are the Advantages of Botulinum Toxin?

The advantages of botulinum toxin injections include:

  • Improvement of discomfort related to spasticity symptoms
  • Decreased spasticity, making it easier to move the body part
  • In some cases, improved ability to use the affected part of the body

The medication is usually effective for two to six months, depending on the individual.

What Are the Disadvantages of Botulinum Toxin?

The disadvantages of botulinum toxin include:

  • The dose (amount) of botulinum toxin that can be injected each time is limited. Therefore, botulinum toxin may not be a good choice of treatment when many muscles are involved or when the spastic muscles are large ( leg muscles).
  • The effect of the injections is temporary. So, injections may need to be repeated multiple times to maintain the beneficial effects. Injections are not repeated more often than every 3 months to minimize the risk of developing antibodies to the botulinum toxin (see below).

What Are the Side Effects?

Side effects of botulinum toxin include:

  • Temporary weakness in the muscle and surrounding muscles that may interfere with the use of the injected muscle
  • Flu-like symptoms, though rare, may develop one week after the injections, but usually only last for about one day.

What Does it Mean to "Develop Antibodies" to Botulinum Toxin?

There is a slight chance that you may develop antibodies to botulinum toxin. Antibodies to botulinum toxin cause the botulinum toxin to be less effective. To minimize the risk of developing antibodies, specific guidelines are followed to restrict the frequency and dose of the medication.

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