Successful Treatment of Recalcitrant Restless Legs Syndrome With Botulinum Toxin Type-A

Rotenberg, Joshua S.; Cannard, Kevin; DiFazio, Marc

doi:10.5664/jcsm.26585

Cited by 19 publications

(9 citation statements)

References 14 publications

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“…There have been several open-label trials [ 276 , 277 ] and case series [ 278 ] that have studied response of RLS to BoNT. A case series with three patients [ 277 ] and another case series with 27 patients [ 276 ] failed to show improvement of RLS symptoms with BoNT.…”

Section: Discussion Of Bont Use In Different Indicationsmentioning

confidence: 99%

Botulinum Toxin in Movement Disorders: An Update

Anandan

Jankovic

2021

Toxins

106

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Since its initial approval in 1989 by the US Food and Drug Administration for the treatment of blepharospasm and other facial spasms, botulinum toxin (BoNT) has evolved into a therapeutic modality for a variety of neurological and non-neurological disorders. With respect to neurologic movement disorders, BoNT has been reported to be effective for the treatment of dystonia, bruxism, tremors, tics, myoclonus, restless legs syndrome, tardive dyskinesia, and a variety of symptoms associated with Parkinson’s disease. More recently, research with BoNT has expanded beyond its use as a powerful muscle relaxant and a peripherally active drug to its potential central nervous system applications in the treatment of neurodegenerative disorders. Although BoNT is the most potent biologic toxin, when it is administered by knowledgeable and experienced clinicians, it is one of the safest therapeutic agents in clinical use. The primary aim of this article is to provide an update on recent advances in BoNT research with a focus on novel applications in the treatment of movement disorders. This comprehensive review of the literature provides a critical review of evidence-based clinical trials and highlights recent innovative pilot studies.

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Section: Discussion Of Bont Use In Different Indicationsmentioning

confidence: 99%

Botulinum Toxin in Movement Disorders: An Update

Anandan

Jankovic

2021

Toxins

106

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“…There was no significant improvement of the IRLS score or clinical global improvement score in the Onabot-A group compared to placebo 99. Two other small open studies (three and eight patients) showed improvement in the control of leg movements with Onabot-A 100,101. Ghorayeb and colleagues,102 in another open-label study, assessed the efficacy of intradermal injection of Abobot-A (250 units to the anterior and posterior thigh muscles) in 26 patients with severe RLS.…”

Section: Use Of Bont For Restless Legs Syndromementioning

confidence: 83%

Use of botulinum toxin for movement disorders

Camargo¹,

Teive²

2019

DIC

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The term movement disorders encompasses all disorders hypokinetic and hyperkinetic, which were previously known as extrapyramidal syndromes. With the definition of movement disorders and their diagnostic criteria and classifications, new studies for therapeutics could be performed. New drugs were launched, functional neurosurgery was developed, and the introduction of botulinum toxin (BoNT) for hyperkinesias was introduced. BoNT is an important therapy for dystonia, tics, myoclonus, and tremors. The aim of this review is to present the new and well-established uses of BoNT for movement disorders.

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“…Previous studies assessing the efficacy of botulinum toxins in RLS produced conflicting results. In 2006, Rotenberg [ 21 ] first reported improvement of urge to move legs, nocturnal restlessness, and leg discomfort after injection of Onabotulinumtoxin A (OnaA) into tibialis anterior muscles. In an open label study, eight patients with moderate to severe RLS were injected with OnaA (25 units in each tibialis anterior muscle) [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Three open label studies and a single, small, randomized double-blind pilot study have evaluated the efficacy of BoNTs in RLS [ 18 , 19 , 20 , 21 ]. These studies demonstrated mixed results with an unclear consensus.…”

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin in Restless Legs Syndrome—A Randomized Double-Blind Placebo-Controlled Crossover Study

Mittal

Machado

Richardson

et al. 2018

Toxins

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Background: Restless Legs Syndrome (RLS) is a common movement disorder with an estimated prevalence of up to 12%. Previous small studies with onabotulinumtoxin A (OnaA) for RLS have shown inconsistent results. Methods: Twenty-four patients with an International RLS score (IRLS) of >11 (moderate-severe) were enrolled in this blinded, placebo-controlled crossover study. Twenty-one patients completed the evaluations at 4, 6, and 8 weeks after each injection. One-hundred units of Incobotulinumtoxin A (IncoA) or normal saline were injected into tibialis anterior, gastrocnemius, and biceps femoris muscles each side. Results: Improvement from a severe (IRLS >21) to a mild/moderate (IRLS ≤20) score was significant at four weeks (p = 0.0036) and six weeks (p = 0.0325) following IncoA administration compared to placebo. Additionally, there was significant improvement in pain score at six weeks as measured by Visual Analogue Scale (p = 0.04) and the Johns Hopkins Quality of Life Questionnaire (p = 0.01) in the IncoA group. Definite or marked improvement on Patient Global Impression of Change was seen in 7 out of 21 patients in the IncoA group vs. 1 out of 21 patients in the placebo group at 4 weeks (p = 0.012). Conclusion: IncoA injection lead to a reduction in severity of RLS symptoms, pain score, and quality of life, without any adverse effects.

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Successful Treatment of Recalcitrant Restless Legs Syndrome With Botulinum Toxin Type-A

Abstract: Disclosure StatementThis was not an industry supported study. Dr. DiFazio has participated in speaking engagements supported by Alleyum, Inc. Drs. Rotenberg and Cannard have indicated no financial conflicts of interest.

Cited by 19 publications

References 14 publications

Botulinum Toxin in Movement Disorders: An Update

Botulinum Toxin in Movement Disorders: An Update

Use of botulinum toxin for movement disorders

Botulinum Toxin in Restless Legs Syndrome—A Randomized Double-Blind Placebo-Controlled Crossover Study

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