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

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

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Departamento de Neurologia, Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Departamento de Medicina Interna, Serviço de Neurologia, Unidade de Distúrbios do Movimento, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil.


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.

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