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Master Thesis

Indications de la toxine botulique, seule ou associée au baclofène intrathécal, dans le traitement de la spasticité chez des patients atteints de sclérose en plaques

Abstract : Background: Multiple sclerosis is a common disease resulting in many disabilities sometimes caused by spasticity. Today spasticity can be safely and effectively treat with botulinum toxin or intrathecal baclofen when it becomes inconvenient. Indications of botulinum toxin in multiple sclerosis are not described. The purpose of this study is to point out objectives and indications of botulinum toxin alone or associated with intrathecal baclofen to treat spasticity in multiple sclerosis. Methods: All patients with multiple sclerosis followed in the “spasticity” unit in 2013 for an injection of botulinum toxin were included. Results: 41 patients with a median EDSS score of 7.5 [ 3-9.5 ] received an injection of botulinum toxin with a functional objective in 58.5% of the cases. 63.4% of injections were performed in the lower limbs. Patients with EDSS score lower than 7 had only injections of botulinum toxin in the lower limbs with essentially a functional objective, the most frequently injected muscle being the triceps surae. Patients with an EDSS greater than or equal to 7 were most often injected in the upper limbs. These patients mainly received botulinum toxin injections with an analgesic or orthopedic objective. Besides intrathecal baclofen, 18.4% of patients having a pump, received toxin botulinum injections to treat spasticity. Those patients had a median EDSS score of 8 [7-9.5]. Injections have been performed mainly in the upper limbs, and to a lesser extent in the upper part of the trunk. Conclusion: It would be interesting to complete this work with a prospective, multicenter study of larger numbers to better cover all indications in these patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01114326
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Submitted on : Monday, February 9, 2015 - 11:27:19 AM
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  • HAL Id : dumas-01114326, version 1

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Angélique Brotier-Chomienne. Indications de la toxine botulique, seule ou associée au baclofène intrathécal, dans le traitement de la spasticité chez des patients atteints de sclérose en plaques. Médecine humaine et pathologie. 2014. ⟨dumas-01114326⟩

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