A Retrospective Study on Botulinum Toxin Injection in Patients With Multiple Sclerosis Related Tremor: A Treatment Option Worth Trying.

IF 0.8 4区医学 Q4 CLINICAL NEUROLOGY

Clinical Neuropharmacology Pub Date : 2024-09-17 DOI:10.1097/WNF.0000000000000614

Ozge Gonul Oner, Ozdem Erturk Cetin, Demir Serkan

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引用次数: 0

Abstract

Objectives: Multiple sclerosis (MS)-related tremor remains a disabling problem that often responds poorly to medical treatments. This study aims to evaluate the effect of botulinum toxin type A on MS-related upper limb tremor.

Methods: This retrospective observational cohort study included 8 patients who received intramuscular injections of onabotulinum toxin type A for medically refractory MS-related tremor. Hospital records before and 4-6 weeks after treatment, including the Fahn-Tolosa-Marin Tremor rating scale (FTM-TRS), electrophysiological tremor analysis, neurological examination findings, and videos, were reviewed retrospectively.

Results: There was significant improvement after botulinum toxin injection in the FTM TRS part A score for tremor (P = 0.011), FTM TRS part B score for hand function (P = 0.011), FTM Part score for activities of daily living (P = 0.012), and FTM TRS total score for overall evaluation (P = 0.012). Electrophysiological tremor analysis revealed maximal tremor amplitudes between 700-2000 μV (before treatment) and between 300-1000 μV (after treatment). The mean tremor amplitudes before and after treatment were 1350 μV and 725 μV, respectively. No adverse reactions were observed after botulinum toxin treatment.

Conclusions: BoNT may improve upper limb tremor and functionality in MS-related tremor. The treatment involved administering BoNT under EMG guidance, with careful muscle selection based on clinical assessment and EMG findings. This approach aimed to optimize treatment efficacy while minimizing potential adverse effects. Further studies are warranted to confirm these findings.

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肉毒杆菌毒素注射治疗多发性硬化症相关震颤患者的回顾性研究：值得一试的治疗方案

目的：多发性硬化症（MS）相关震颤仍是一个致残性问题，通常对药物治疗反应不佳。本研究旨在评估 A 型肉毒毒素对多发性硬化症相关上肢震颤的影响：这项回顾性观察队列研究纳入了 8 名接受肌肉注射 A 型肉毒毒素治疗药物难治性多发性硬化症相关震颤的患者。研究人员回顾性审查了治疗前和治疗后4-6周的住院记录，包括法恩-托洛萨-马林震颤评分量表（FTM-TRS）、电生理震颤分析、神经系统检查结果和视频：结果：注射肉毒毒素后，患者的震颤评分量表（FTM TRS）A部分得分（P = 0.011）、手部功能评分量表（FTM TRS）B部分得分（P = 0.011）、日常生活活动评分量表（FTM Part）得分（P = 0.012）和总体评估总分（FTM TRS）得分（P = 0.012）均有明显改善。电生理震颤分析显示，最大震颤幅度在 700-2000 μV 之间（治疗前）和 300-1000 μV 之间（治疗后）。治疗前后的平均震颤幅度分别为 1350 μV 和 725 μV。肉毒杆菌毒素治疗后未观察到不良反应：结论：BoNT 可改善多发性硬化症相关震颤患者的上肢震颤和功能。治疗包括在肌电图指导下使用 BoNT，并根据临床评估和肌电图结果仔细选择肌肉。这种方法旨在优化疗效，同时将潜在的不良反应降至最低。我们需要进一步研究来证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neuropharmacology 医学-临床神经学

CiteScore

1.20

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Neuropharmacology is a peer-reviewed journal devoted to the pharmacology of the nervous system in its broadest sense. Coverage ranges from such basic aspects as mechanisms of action, structure-activity relationships, and drug metabolism and pharmacokinetics, to practical clinical problems such as drug interactions, drug toxicity, and therapy for specific syndromes and symptoms. The journal publishes original articles and brief reports, invited and submitted reviews, and letters to the editor. A regular feature is the Patient Management Series: in-depth case presentations with clinical questions and answers.