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Your Health: Botox helps MS patients
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Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord which affects more than 400,000 Americans.
Kristen M. Longo
Public Relations Specialist
LIJ Health System
(516) 465 -2607
The disease is caused by damage to the protective covering that surrounds nerve cells, called the myelin sheath. When these nerve cells are damaged it causes nerve signals to slow down or stop completely. The nerve damage is usually caused by inflammation that occurs when the body's own immune cells attack the nervous system occurring in any area of the spinal cord, brain and optic nerve.
So far the cause of this disease is unknown, but commonly it is thought to happen because of either a virus or gene defect. People who have a family history of MS or live in an area where MS is more common might be more likely to develop this disease.
Many people, including those with Multiple Sclerosis, find that their bladder becomes troublesome at some point in their lives. The bladder has complex nerve controls which are easily disrupted. This can lead to an overactive or "unstable" bladder, which needs emptying very often and in a hurry. If a toilet is not reached in time, urge incontinence can result.
Alternatively, nerve damage can mean that the bladder does not empty properly, leading to overflow incontinence and other possible bladder problems or a bladder which fluctuates between the two patterns. Current management of this condition includes medications to relax the bladder and use of a catheter to regularly empty the bladder.
The U.S. Food and Drug Administration approved Botox injection to treat urinary incontinence in people with neurologic conditions such as spinal cord injury and multiple sclerosis who have over activity of the bladder. The treatment consists of Botox being injected into the bladder resulting in relaxation of the bladder, an increase in its storage capacity and a decrease in urinary incontinence.
Injection of the bladder with Botox is performed using cystoscopy, a procedure that allows a doctor to visualize the interior of the bladder. The duration of the effect of Botox on urinary incontinence in patients with bladder over activity associated with a neurologic condition is up to 10 months.
The effectiveness of Botox to treat this type of incontinence was demonstrated in two clinical studies involving 691 patients. The patients had urinary incontinence resulting from spinal cord injury or multiple sclerosis. Both studies showed statistically significant decreases in the weekly frequency of incontinence episodes in the Botox group compared with placebo.
The most common adverse reactions observed following injection of Botox into the bladder were urinary tract infection and urinary retention. Those who develop urinary retention after Botox treatment may require self-catheterization to empty the bladder.