Botulinum Toxin in Patients With Spastic Lower Limb Paresis Associated With Multiple Sclerosis

Inclusion Criteria

• •Acceptance and signature of informed consent.
• •Age between 18 and 80 years old, both included.
• •Patients with relapsing remitting multiple sclerosis (RRMS), progressive secondary (SP) and primary progressive (PP), with spasticity resistant to usual treatment, either because of the severity of the spasticity or because of intolerance to side effects.
• •Outpatients with spastic paraparesis that causes gait deficiency.
• •Patients with an EDSS score between 2 and 6, both included.
• •Patients with segmental involvement in MAS \>1 in two or more muscle groups in the lower extremities.
• •Absence of cognitive disability. Score less than 5 on the SPMSQ scale of Pfeiffer.
• •Possibility of carrying out the treatment (method of administration, scheduled visits) and scales correctly.
• •Women of childbearing potential should use an effective contraceptive method (hormonal contraceptives, intrauterine device, condom) or refrain from having sex in order not to get pregnant. A woman is considered to be fertile after menarche and to become postmenopausal, unless she has undergone a permanent sterilization procedure (hysterectomy, salpingectomy, bilateral oophorectomy). A postmenopausal state is defined as absence of menstruation for 12 months without an alternative medical cause.