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CMSC 2026

Botulinum Toxin Injections for Migraine and Spasticity in Multiple Sclerosis: A Hands-On Training Symposium

Moderator/Chair: Carolina Ionete , MD, PhD
This hands-on workshop is designed to transition participants from theoretical knowledge to clinical application, covering both upper and lower extremities. • Didactic Sessions: Participants will learn the mechanisms of action, therapeutic indications for MS-related spasticity, goal setting (e.g., using Goal Attainment Scaling), and patient selection criteria. • Anatomy and Injection Techniques: In-depth review of muscle anatomy and localization techniques, including anatomical landmarks, Electromyography (EMG), Electrical Stimulation, and Ultrasound guidance for precision. • Hands-on Practice: Small group, supervised training on models allows participants to practice reconstitution, dosage determination, and needle placement. • Clinical Focus: Training covers common MS-related focal spasticity patterns, such as equinovarus foot, toe clawing, knee recurvatum, and upper limb stiffening. Level of Information: IntermediateThis hands-on workshop is designed to transition participants from theoretical knowledge to clinical application, covering both upper and lower extremities. • Didactic Sessions: Participants will learn the mechanisms of action, therapeutic indications for MS-related spasticity, goal setting (e.g., using Goal Attainment Scaling), and patient selection criteria. • Anatomy and Injection Techniques: In-depth review of muscle anatomy and localization techniques, including anatomical landmarks, Electromyography (EMG), Electrical Stimulation, and Ultrasound guidance for precision. • Hands-on Practice: Small group, supervised training on models allows participants to practice reconstitution, dosage determination, and needle placement. • Clinical Focus: Training covers common MS-related focal spasticity patterns, such as equinovarus foot, toe clawing, knee recurvatum, and upper limb stiffening. Level of Information: Intermediate

Presentations in This Session

Key Mechanisms of Spasticity in MS

Speaker/s: Carolina Ionete, MD, PhD

Treatment Algorithms to Assist with Selection of Modalities

Speaker/s: Agnes Bacopulos, MD

Botulinum Toxin (BoNT) Mechanism of Action and Indications for Treatment in Neurological Disorders

Speaker/s: Molly Wilner, DO

Evaluating Spasticity and Choosing Muscle to Treat in the Upper Extremity and Lower Extremity (FDA Approved Muscles)

Speaker/s: Idanis Berrios Morales, MD