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Botox may help multiple sclerosis tremors


5 Star


Botox may help multiple sclerosis tremors

Our Review Summary

Especially noteworthy were the caveats and discussion of limitations.


Why This Matters

People with MS might understandably leap at any news of progress.  This story was strong on evidence and caution and appropriately low key on excitement.


Does the story adequately discuss the costs of the intervention?


The story explains: “the cost could range from $500 to $1,000 Australian dollars, which are roughly equal to U.S. dollars. In the U.S., Botox treatments can cost $455-$575 per injection site.”

Does the story adequately quantify the benefits of the treatment/test/product/procedure?



The story reported:

On average, the patients’ tremor “scores” had gone from a 5 to a 3 six weeks after Botox treatment — which essentially means moving from “moderate” to “mild,” LaRocca said. Their ability to write and draw a straight line had also improved by week six, and the benefits were still there at week 12.

In contrast, there were no improvements after the placebo injections.

But the “on average” doesn’t tell much about the range of progress across the 23 people.  That wouldn’t have been difficult to explain.

Does the story adequately explain/quantify the harms of the intervention?


The story stated:

Muscle weakness was the most common side effect in this study, van der Walt said. It affected 42 percent of the study patients, though it went away within two weeks.

Muscle weakness is a potential concern in MS patients, LaRocca noted, since that problem often comes with the disease itself.

Does the story seem to grasp the quality of the evidence?


Good context provided.  Example:

“This study is fairly preliminary, and it had a small number of patients,” LaRocca said. Larger studies, of more-diverse groups of MS patients, are needed, he said.

The study’s lead researcher agreed on the need for more work. “There are several questions that need to be answered by doing larger and longer-term studies,” Dr. Anneke van der Walt, a neurologist at Royal Melbourne Hospital in Australia, said in an email.

One is how long the benefits of repeat Botox injections might last: this study tested the effects of just one Botox treatment over three months.

In real life, the injections would have to be repeated every few months, or possibly every six months for some people, according to van der Walt. Another question is whether the side effects change over time.

Does the story commit disease-mongering?


No disease mongering at play here.

Does the story use independent sources and identify conflicts of interest?


Actually, most of the quotes came from an independent perspective.

Does the story compare the new approach with existing alternatives?


A VP at the National MS Society said “Right now there’s no good way to treat MS arm tremors.”

Does the story establish the availability of the treatment/test/product/procedure?


The availability of Botox was clear in the story.

Does the story establish the true novelty of the approach?

Not Satisfactory

The novelty of this approach is not made clear in the story.  Is this the first look at Botox for this use?  Is there any comparable work?

Does the story appear to rely solely or largely on a news release?


It’s clear that the story did not rely on a news release.

Total Score: 9 of 10 Satisfactory

Comments (2)

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mickie thomas

November 8, 2012 at 12:34 pm

Has this been tried with tremors of Parkinson patients?