Botulinum Toxin Type A
Indication
Contracture of the joint in Multiple Sclerosis
Red
Brand:
All brands within licensed indications only
Nice TA:
Commissioning responsibility:
CCG
PbR excluded:
Yes
BNF chapter:
Central nervous system
Background
NICE CG186 does not make a recommendation on use of botulinum toxin A for contracture of the joint in MS and states that problems are ‘complex and need individual assessment. Botulinum injection along with prolonged stretching modalities using serial plaster casts, standing frames or removable splints, has been approved locally after a review of audit data, provided
-
treatment is restricted to those patients who have failed or could not have other treatments
-
treatment is only initiated by an appropriate specialist with experience in use of botulinum toxin A, that there are clearly defined goals of treatment — set prior to initiation and against which patients will be reviewed at each injection cycle.