"Botox injections may provide some relief from arm tremors caused by multiple sclerosis according to a small study published Monday. Botulinum toxin type A is sold under different brands but its best known by the Allergan brandname Botox.  A sample of Botox is seen at the Long Island Plastic Surgical Group at the Americana Manhasset luxury shopping destination in Manhasset New York September  . REUTERSShannon Stapleton Botox gained fame for smoothing aging skin  by blocking nerve signals and relaxing muscles under the skin  but the product has a number of medical uses. In the U.S. Botox is approved to treat conditions like chronic migraine excessive sweating and certain symptoms of MS overactive bladder and muscles spasms in the arms.  The new study published in the journal Neurology tested the effects of Botox injections on MSrelated arm tremors which affect up to twothirds of people with MS. Researchers found that when they gave injections to  patients the treatment typically eased their tremors and improved their writing ability.  Right now theres no good way to treat MS arm tremors said Nicholas G. LaRocca vicepresident of healthcare delivery and policy research at the National MS Society. Physical therapy and exercise have been studied but are usually not very effective said LaRocca who was not involved in the new study. Surgery is sometimes used in severe cases but its risky and may not even have lasting benefits.  Exploring new treatments is important and its heartening to see theres some promise here LaRocca said of the current findings. But theres still a lot to be learned he cautioned in an interview.  This study is fairly preliminary and it had a small number of patients LaRocca said. Larger studies of morediverse groups of MS patients are needed he said.  The studys lead researcher agreed on the need for more work. There are several questions that need to be answered by doing larger and longerterm 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. Muscle weakness was the most common side effect in this study van der Walt said. It affected  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.  The study included  MS patients with mild to moderate arm tremors. Each patient received a round of Botox injections and a round of placebo injections containing saline three months apart. Half of the patients got the Botox first the other half the placebo.  On average the patients tremor scores had gone from a  to a  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 .  In contrast there were no improvements after the placebo injections.  Larger studies van der Walt said should look at whether Botox is more effective for some tremors than others. Tremors limited to the hand and forearm for instance might respond better than tremors that also affect the shoulder. If Botox is eventually approved for this MS symptom LaRocca said it will be important for doctors to get training in how to give the injections  since the drug has to go into carefully chosen locations in the muscle.  So practitioners will have to be up to speed LaRocca said. There will also be the matter of cost. That will vary from patient to patient depending on how many injections are needed per treatment.  According to van der Walt the cost could range from  to  Australian dollars which are roughly equal to U.S. dollars. In the U.S. Botox treatments can cost  per injection site.  Botox maker Allergan supplied the product for the study and two of the researchers on the work have financial ties to the company. The study itself was funded by the Box Hill MS Research Fund and the Royal Melbourne Hospital.  SOURCE bit.lylUcacJ httpbit.lylUcacJ Neurology online July  . Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"