Botulinum toxin for hereditary spastic paraplegia: effects on motor and non-motor manifestations

Arq Neuropsiquiatr. 2018 Mar;76(3):183-188. doi: 10.1590/0004-282x20180013.


Motor and non-motor manifestations are common and disabling features of hereditary spastic paraplegia (HSP). Botulinum toxin type A (Btx-A) is considered effective for spasticity and may improve gait in these patients. Little is known about the effects of Btx-A on non-motor symptoms in HSP patients. Objective To assess the efficacy of Btx-A on motor and non-motor manifestations in HSP patients. Methods Thirty-three adult patients with a clinical and molecular diagnosis of HSP were evaluated before and after Btx-A injections. Results Mean age was 41.7 ± 13.6 years and there were 18 women. Most patients had a pure phenotype and SPG4 was the most frequent genotype. The Btx-A injections resulted in a decrease in spasticity at the adductor muscles, and no other motor measure was significantly modified. In contrast, fatigue scores were significantly reduced after Btx-A injections. Conclusion Btx-A injections resulted in no significant functional motor improvement for HSP, but fatigue improved after treatment.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adult
  • Age of Onset
  • Botulinum Toxins, Type A / therapeutic use*
  • Female
  • Gait / drug effects
  • Gait / physiology
  • Humans
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Motor Disorders / drug therapy*
  • Motor Disorders / physiopathology*
  • Muscle Fatigue / drug effects
  • Muscle Fatigue / physiology
  • Muscle Spasticity / drug therapy
  • Muscle Spasticity / physiopathology
  • Neuromuscular Agents / therapeutic use*
  • Reproducibility of Results
  • Spastic Paraplegia, Hereditary / drug therapy*
  • Spastic Paraplegia, Hereditary / physiopathology*
  • Treatment Outcome


  • Neuromuscular Agents
  • Botulinum Toxins, Type A