Uses of Botox in MS

botox-needle

What is Botox

Botox is purified botulinum toxin, produced by the bacterium Clostridium botulinum. It began to be used for medical purposes in around 1980 when weakening eye muscles using the toxin was used to treat a condition where the eyes don’t line up properly.

In small doses, Botox causes weakness in muscles which is used to alleviate the symptoms of overactive muscle activities. This is especially important in illnesses such as overactive bladder and some spasticity in MS. Botox is also used in the cosmetic industry for smoothing out lines and wrinkles, and this is the use which people will most famously associate it with. I am not going to talk about that because you can all go and look about that online!!

Muscle issues are involved in a massive range of medical conditions, this means that Botox has a massive range of medical applications. Botox can be used for people who sweat profusely. I had a friend who received injections to reduce her sweating and it worked amazingly well for her. It is also used for migraine and for treating certain aspects of Parkinson’s. A rather new and more unusual application of Botox is for the treatment of depression. Whilst there is some dispute over how the Botox works, it is thought that through paralysing the muscles in the forehead, patients are unable to frown and therefore place people in a better mood.

What wait… Botox is used in MS?

Yes – Botox is used to treat many of the symptoms of MS. In patients who are suffering with spasticity in their legs or arms, it can be good to relieve the pain and also improve some of the mobility. In some cases it mean that patients who were originally unable to dress and wash themselves regain some of their function back.

Botox is also used in overactive bladder and when patients suffer with their vocal cords. The reason that I became interested in it was because I am going to have Botox in my bladder and wanted to know more about it!

What is overactive bladder?

You might have read one of my previous blogs about this actually – but in a nutshell an overactive bladder might mean that when you need to wee you typically need it right away (urgency), you need to frequently urinate more than 6-8 times a day, and you may leak wee.

How does Botox work?

Botox works by blocking the release of a neurotransmitter called acetylcholine from the nerve endings. This neurotransmitter is required to make muscles contract. The Botox stops this and this means that the bladder (or the other muscle that the Botox is injected into) is relaxed. Apparently the blockage of the acetylcholine does not happen straight away, and it might take up to five days. Also Botox is not permanent and patients will need to go and get the injections again every 6-9 months (apparently shorter if it is into spastic muscles)

How on earth do they get the Botox into your bladder?

Good question and one that I wanted to know myself!! I went along and this was the first question I asked the urologist. So apparently (and I have not had this done yet…) they use a thin tube called a cystoscope which is inserted into your bladder. A tiny camera is attached to the tube so the surgeon can look at the inside of you. Through the tube the surgeon makes about twenty injections of Botox into specific sites of the bladder wall. WOW. Apparently I am reassured that this is quite painless. 

According to the MS nurses and the urologist, anaesthetic gel is put into the urethra to numb it, and I should not feel anything. In most cases the tube will be inserted for less than five minutes. It is quite a simple and routine procedure according to the local team in my area. 

Are there any side effects?

Well there are some as it happens but actually some of these are preferable to what I have been dealing with due to my OAB. According to the urologist, around a fifth of people struggle with seeing after they have been treated. Although they say that this might last a couple of days, in a few people it might be a longer term issue and they ask you to learn to catheterise. 

There are also warnings of increased risk of infection usually due to not taking hygiene precautions.

Anyway – that is me done for now. Please do not quote me on the information here as I am NOT a medical practitioner. I am going to be having my own bladder botox soon and will keep you updated on the progress and also whether it works etc.

Keep well and keep on staying strong and positive

Z

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