Efficacy of Botulinum Toxin <scp>A</scp> for Treating Cramps in Diabetic Neuropathy

Restivo, Domenico A.; Casabona, Antonino; Frittitta, Lucia; Belfiore, Antonino; Moli, Rosario Le; Gullo, Damiano; Vigneri, Riccardo

doi:10.1002/ana.25340

Cited by 15 publications

(12 citation statements)

References 42 publications

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“…This significant improvement in pain score is comparable to the results of the study conducted in 1997 by Bertolasi et al where they used botulinum toxin to manage cramps in 5 patients with benign cramps -fasciculation syndrome. [16] The study used clinical and neurophysiological variables collected before and after the administration of botulinum toxin to assess its effects. A significant lowering of clinical cramp severity scores and a significant increase in cramp threshold frequencies was noted.…”

Section: Discussionmentioning

confidence: 99%

“…Botulinum toxin A (BTX-A) is known to reduce hyperactivity of a muscle by blockade of acetylcholine release at neuromuscular junction thereby leading to muscle relaxation [14,15] This property of botulinum toxin has been used successfully to manage cramps in patients with diabetic neuropathy and patients with benign fasciculation syndrome. [16,17] Our study aims to assess the efficacy of botulinum toxin A (BTX A) in a well-defined cohort of patients with peripheral neuropathy who suffered from cramps due to various etiologies.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of botulinum toxin for treating cramps in peripheral neuropathy

Mehta

Sommers

Govindarajan

2021

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Abstract Introduction: Muscle cramps are a common occurrence in patients with peripheral neuropathy and are known to cause significant distress and decrease the quality of life. Although several drug formulations have been used in the management of cramps, there is significant variability in terms of efficacy and tolerability in patients with peripheral neuropathy. This study aims to assess the efficacy of botulinum toxin A in the management of lower limb cramps in patients with peripheral neuropathy. Methods: This retrospective chart review included a total of ten patients with peripheral neuropathy with cramps. Relevant data such as age, gender, race, pain score and cause of peripheral neuropathy were documented. Statistical analyses to compare the variables was done using the Wilcoxon Test. The pain score before the administration, at 3-month, 6 month and 9 months follow up were compared. Results All patients enrolled in the study showed improvement of pain assessed by visual pain analog scale. An improvement of 1.60 (95%CI, p<0.05), 2.70 (95%CI, p<0.05) and 3.50 (95%CI, p=0.05) was noted between test scores from before administration of botulinum toxin to 3-month, 6 months and 9 months follow up with a range of 6, 4 and 4 respectively. Conclusion: Local BTX-A infiltration is a likely efficacious and safe procedure for improving pain associated with cramps in patients with peripheral neuropathy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of botulinum toxin for treating cramps in peripheral neuropathy

Mehta

Sommers

Govindarajan

2021

rrnmf

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“…Our study assessed the efficacy of BTX-A which has been reported to effectively manage cramps in other conditions including benign fasciculation syndrome and diabetic neuropathy. [33,36,37] The property of relaxing the muscle by preventing acetylcholine release at the neuromuscular junction has been utilized in ALS patients to manage spasticity, sialorrhea and dysphagia. [38,39,40] Table 2 summarizes the different studies that used medications to manage pain as a result of cramps in patients with ALS.…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin for the treatment of lower limb cramp pain in patients with Amyotrophic Lateral Sclerosis

Mehta

Sommers

Govindarajan

2020

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Background: Muscle cramps and pain associated with them can be seen in patients with amyotrophic lateral sclerosis (ALS) and are known to reduce the quality of life. Pharmacological treatment may not benefit all patients in treating these cramps. We assess the efficacy of Onabotulinum toxin A (BTX-A) in the treatment of lower limb cramps in patients with ALS. Methods: This retrospective chart review included a total of ten patients with ALS who suffered from pain due to lower limb cramps and were managed with BTX-A. Data including patient demographics, visual analog pain scale at different intervals during follow up, ALS functional rating scale and site of onset of ALS symptoms were documented. The pain score at baseline (before administration), at 3 months follow up and at 6 months follow up were compared using Wilcoxon test to assess BTX-A’s efficacy. Results: A significant improvement in average pain score due to cramps from baseline to the 6-month interval with a change of 3.1±0.7 (p<0.05,95%CI) was seen on the pain scale. No adverse events were noted during administration or post injections. Conclusion: Local BTX-A administration is an efficacious and safe procedure for improving pain associated with cramps in patients with ALS.

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“…Botulinum toxin A has shown some promise in treating areas of muscle hyperactivity associated with neuropathy. [47].…”

Section: Treatmentmentioning

confidence: 99%