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Botulinum Toxin a Shot in the Arm for Preventing MS Tremor

Botulinum toxin may help prevent shaking or tremor in the arms and hands of people with multiple sclerosis (MS), according to new research published in the July 3, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology.

“Treatments in use for tremor in MS are not sufficiently effective and new alternatives are needed,” said study author Anneke van der Walt, MD, consultant neurologist at The Royal Melbourne Hospital and research fellow with the University of Melbourne in Australia.

For the study 23 people with MS were given botulinum toxin type A injections or a saline placebo for three months. Then they received the opposite treatment for the next three months. Scientists measured the tremor severity and their ability to write and draw before, during and after receiving the treatments. Video assessments were also taken every six weeks for six months.

The study found that people saw significant improvement in tremor severity, writing and drawing at six weeks and three months after the botulinum toxin treatment compared to after placebo. In tremor severity, the participants improved an average of two points on a 10-point scale, bringing their tremor from moderate to mild. In writing and drawing, participants improved by an average of one point on a 10-point scale.

“Our study suggests a new way to approach arm tremor related to MS where there are currently major treatment challenges and it also sets the framework for larger studies,” said van der Walt.

Muscle weakness developed in 42 percent of people after treatment with botulinum toxin compared to six percent after placebo. The weakness was generally mild and went away within two weeks.

The study was supported by the Box Hill MS Research Fund and The Royal Melbourne Hospital Neuroscience Foundation.

To learn more about multiple sclerosis, visit

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy.

For more information about the American Academy of Neurology, visit

Rachel L. Seroka | American Academy of Neurology
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