Treatment of spasticity with botulinum toxin: a double-blind study

Ann Neurol. 1990 Oct;28(4):512-5. doi: 10.1002/ana.410280407.


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 short-term trial. This is the first demonstration of the beneficial effect of botulinum toxin on focal spastic muscle contractions.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Botulinum Toxins / therapeutic use*
  • Double-Blind Method
  • Drug Evaluation
  • Female
  • Humans
  • Hygiene
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / nursing
  • Muscle Spasticity / drug therapy*
  • Muscle Spasticity / etiology
  • Pilot Projects
  • Random Allocation
  • Severity of Illness Index


  • Botulinum Toxins