Botulinum toxin type A for amyotrophic lateral sclerosis lower limb spasm: two case reports

Abstract Background Patients with amyotrophic lateral sclerosis (ALS) often experience spasticity, which can severely affect their ability to perform basic activities like standing and walking, potentially diminishing their already compromised quality of life. Botulinum toxin type A (BTX-A) is a fir...

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Main Authors: Qiang Duan, Chao Li, Chunxia Wei, Qian Wang, Bo Wang, Liangwen Sun, Yongjing He, Junxia Qin, Xiaoqun Huang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-025-04266-6
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author Qiang Duan
Chao Li
Chunxia Wei
Qian Wang
Bo Wang
Liangwen Sun
Yongjing He
Junxia Qin
Xiaoqun Huang
author_facet Qiang Duan
Chao Li
Chunxia Wei
Qian Wang
Bo Wang
Liangwen Sun
Yongjing He
Junxia Qin
Xiaoqun Huang
author_sort Qiang Duan
collection DOAJ
description Abstract Background Patients with amyotrophic lateral sclerosis (ALS) often experience spasticity, which can severely affect their ability to perform basic activities like standing and walking, potentially diminishing their already compromised quality of life. Botulinum toxin type A (BTX-A) is a first-line drug for spastic management. However, there are limited reports on its effectiveness in reducing muscle tone among ALS patients, with scarcely any related research conducted in China. We conducted the clinical observation and follow-up study through the relevant ethical post (ChiCTR2200061794). Clinical registration was on July 2, 2022. All participants provided written informed consent. Case presentation We report two cases of middle-aged male patients, both diagnosed with ALS, who presented with symptoms such as limb stiffness and walking limitation due to increased muscle tone in the lower limbs. Based on the spasticity of the patient’s lower limbs, the corresponding target muscles were selected for BTX-A treatment under ultrasound guidance, and the patients were evaluated on relevant functional scales before injection (baseline, T0) and at three follow-up visits (T1: 2 weeks, T2: 4 weeks, T3: 8 weeks). Conclusion Appropriate BTX-A injected into the target muscles could effectively depress the spasticity of ALS patients without apparent side effects.
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issn 1471-2377
language English
publishDate 2025-07-01
publisher BMC
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series BMC Neurology
spelling doaj-art-a91ae02550e14393b2de1554f07a6eaa2025-08-20T03:03:33ZengBMCBMC Neurology1471-23772025-07-012511610.1186/s12883-025-04266-6Botulinum toxin type A for amyotrophic lateral sclerosis lower limb spasm: two case reportsQiang Duan0Chao Li1Chunxia Wei2Qian Wang3Bo Wang4Liangwen Sun5Yongjing He6Junxia Qin7Xiaoqun Huang8Department of Rehabilitation Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s HospitalDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges Universityï¿¿Yichang Central People’s HospitalDepartment of Rehabilitation Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s HospitalDagongqiao Community Health Service CenterDepartment of Rehabilitation Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s HospitalDepartment of Rehabilitation Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s HospitalDepartment of Rehabilitation Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s HospitalDepartment of Rehabilitation Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s HospitalDepartment of Rehabilitation Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People’s HospitalAbstract Background Patients with amyotrophic lateral sclerosis (ALS) often experience spasticity, which can severely affect their ability to perform basic activities like standing and walking, potentially diminishing their already compromised quality of life. Botulinum toxin type A (BTX-A) is a first-line drug for spastic management. However, there are limited reports on its effectiveness in reducing muscle tone among ALS patients, with scarcely any related research conducted in China. We conducted the clinical observation and follow-up study through the relevant ethical post (ChiCTR2200061794). Clinical registration was on July 2, 2022. All participants provided written informed consent. Case presentation We report two cases of middle-aged male patients, both diagnosed with ALS, who presented with symptoms such as limb stiffness and walking limitation due to increased muscle tone in the lower limbs. Based on the spasticity of the patient’s lower limbs, the corresponding target muscles were selected for BTX-A treatment under ultrasound guidance, and the patients were evaluated on relevant functional scales before injection (baseline, T0) and at three follow-up visits (T1: 2 weeks, T2: 4 weeks, T3: 8 weeks). Conclusion Appropriate BTX-A injected into the target muscles could effectively depress the spasticity of ALS patients without apparent side effects.https://doi.org/10.1186/s12883-025-04266-6ALSBTX-AUltrasoundUMNLower limb spasticity
spellingShingle Qiang Duan
Chao Li
Chunxia Wei
Qian Wang
Bo Wang
Liangwen Sun
Yongjing He
Junxia Qin
Xiaoqun Huang
Botulinum toxin type A for amyotrophic lateral sclerosis lower limb spasm: two case reports
BMC Neurology
ALS
BTX-A
Ultrasound
UMN
Lower limb spasticity
title Botulinum toxin type A for amyotrophic lateral sclerosis lower limb spasm: two case reports
title_full Botulinum toxin type A for amyotrophic lateral sclerosis lower limb spasm: two case reports
title_fullStr Botulinum toxin type A for amyotrophic lateral sclerosis lower limb spasm: two case reports
title_full_unstemmed Botulinum toxin type A for amyotrophic lateral sclerosis lower limb spasm: two case reports
title_short Botulinum toxin type A for amyotrophic lateral sclerosis lower limb spasm: two case reports
title_sort botulinum toxin type a for amyotrophic lateral sclerosis lower limb spasm two case reports
topic ALS
BTX-A
Ultrasound
UMN
Lower limb spasticity
url https://doi.org/10.1186/s12883-025-04266-6
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