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We studied the effect of botulinum-A toxin on spasticity of the leg adductors in 9 patients who were either chair-bound or bed-bound with chronic stable multiple sclerosis.We injected botulinum toxin(400 mouse units)or placebo into the adductor muscles in a randomized,crossover, double-blind design.Two physicians,who were unaware of the treatment order,used an objective rating scale and independently assessed the patients;interobserver correlation was excellent(r=0.93-0.81).We found that botulinum toxin produced a significant reduction in spasticity(p=0. 009)and a significant improvement in the ease of nursing care(p=0.009). There were no adverse effects during this shortterm trial.This is the first demonstration of the beneficial effect of botulinum toxin on focal spastic muscle contractions. |
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