Lamotte D, Thoumie P
Service de rééducation neuro-orthopédique, hôpital Rothschild, 33, boulevard de Picpus, 75012 Paris, France.
Ann Readapt Med Phys. 2003 Jul;46(6):299-302. doi: 10.1016/s0168-6054(03)00106-5.
The aim of this work was to collect litterature datas to have an indication of botulinum toxin in multiple sclerosis disease.
The international literature relating the years 1982-2002 was carried out with the Medline data bank. The article presenting of the controlled studies were mainly retained.
Thirty-seven articles were indexed, 6 were retained according to our criteria. The selected articles show mainly a use of botulinum toxin in the spasticity. The principal criteria of evaluation were the muscular tone, the spasms, the pain, the or passive amplitude of joint. Two articles report the effectiveness of toxin injection in acquired nystagmus and the paralysis of a vocal fold.
This review shows that the principal indication of toxin in multiple sclerosis is spasticity with a good effectiveness of the treatment. However controlled-placebo studies among these patients are still very few. The side effects are rare but sometimes appearance of muscular weakness always making discuss the existence of a push. It is necessary to take account of these effects and their consequences before proposing the treatment.
Botulinum toxin has an indication in the treatment of spasticity of patients with multiple sclerosis. However more studies are necessary with more sits of injection to fix the good indications.
这项工作的目的是收集文献数据，以了解肉毒杆菌毒素在多发性硬化症中的应用情况。
利用Medline数据库检索1982年至2002年的国际文献。主要保留了呈现对照研究的文章。
共检索到37篇文章，根据我们的标准保留了6篇。所选文章主要显示肉毒杆菌毒素在痉挛治疗中的应用。主要评估标准为肌张力、痉挛、疼痛以及关节的主动或被动活动幅度。两篇文章报道了毒素注射对后天性眼球震颤和声带麻痹的有效性。
本综述表明，肉毒杆菌毒素在多发性硬化症中的主要适应证是痉挛，且治疗效果良好。然而，这些患者中的对照-安慰剂研究仍然很少。副作用很少见，但有时会出现肌肉无力，这总是让人对是否存在推动因素产生讨论。在提出治疗方案之前，有必要考虑这些影响及其后果。
肉毒杆菌毒素可用于治疗多发性硬化症患者的痉挛。然而，需要进行更多研究，增加注射部位，以确定更好的适应证。
