What is the efficacy of botulinum toxin (BoNT) injections for the treatment of spasticity?

Updated: Jul 13, 2018
  • Author: Divakara Kedlaya, MBBS; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Answer

Answer

Spasticity is defined as a velocity-dependent increase in muscle tone. Intramuscular injections of BoNT have been studied and found to be useful in the treatment of spasticity in multiple sclerosis (MS), cerebral palsy (CP), stroke, traumatic brain injury (TBI), and spinal cord injury (SCI). Different studies have shown the effectiveness of BoNT-A injection in the management of spasticity. [23]

Table 2. Studies of Botulinum Toxin in the Treatment of Spasticity in Different Disorders (Open Table in a new window)

Clinical Diagnosis

Author

Study Design

Multiple Sclerosis

Benecke

Borg-Stein et al [96]

Snow et al [97]

Hyman et al [98]

Open-label

Open-label

Double-blind, placebo-controlled, randomized, crossover

Double-blind, placebo-controlled, randomized, dose-ranging

Spinal Cord Injury

Bohlega et al

Takenaga et al

Open-label

Open-label

Cerebral Palsy

Koman et al [99] Koman et al [100]

Cosgrove et al [101]

Chutorian and Root

Chutorian, Root, and the BTA study group

Corry et al [102]

Fehlings et al [103]

Wissel et al [104]

Baker et al [105]

Edwards et al [106]

Open-label

Double-blind, placebo-controlled

Open-label

Open-label

Double-blind, placebo-controlled, randomized

Double-blind, placebo-controlled

Single-blind, randomized, controlled

Double-blind, randomized, placebo-controlled

Double-blind, randomized, placebo-controlled

Double-blind, randomized, placebo-controlled

Stroke

Das and Park Memin et al

Grazko et al

Dengler et al

Jabbari et al

Simpson et al

Bhaktha et al [107]

Smith et al [108]

Childers et al [109]

Pittock et al [110]

Brashear et al [111]

Bakheit et al [112]

Open-label

Open-label

Double-blind, placebo-controlled, crossover

Open-label

Double-blind, placebo-controlled, crossover

Double-blind, placebo-controlled

Double-blind, placebo-controlled, randomized

Double-blind, placebo-controlled, randomized

Double-blind, placebo-controlled, randomized

Double-blind, placebo-controlled, randomized

Double-blind, placebo-controlled, randomized

Traumatic Brain Injury

Yablon et al [113]

Pavesi et al [114]

Open-label

Open-label


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