Impact on Quality of Life of Botulinum Toxin Treatments for Spasmodic Dysphonia and Oromandibular Dystonia

AbstractBackground:Botulinum toxin injection under electromyographic guidance is the ‘gold standard’ for adductor spasmodic dysphonia treatment. The point-touch technique, an alternative injection method which relies on anatomical landmarks, is cheaper, quicker and more accessible, but has not yet gained widespread acceptance due to concerns about patient satisfaction.Objective:To assess swallowing and voice-related quality of life following point-touch botulinum toxin injection in adductor spasmodic dysphonia patients.Setting:Stanford University Voice and Swallowing Center.Design:Prospective case series (evidence level four).Methods:Consecutive adductor spasmodic dysphonia patients with a stable botulinum toxin dose–response relationship were recruited prospectively. The Eating Assessment Tool and Voice-Related Quality of Life questionnaires were completed pre-treatment and at 10 and 30 per cent completion of the injection cycle, respectively.Results:Thirty-seven patients completed follow up. The mean total botulinum toxin dose was 0.88 units. Pre-treatment Voice-Related Quality of Life questionnaire results reflected the burden of disease. Post-treatment Eating Assessment Tool and Voice-Related Quality of Life questionnaire results were collected at 2.53 and 7.84 weeks, respectively; the former showed an increase in dysphagia, albeit statistically insignificant, while the latter showed significantly improved scores (both domain and total).Conclusion:The point-touch technique is a viable alternative for botulinum toxin injection in the treatment of adductor spasmodic dysphonia.

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Severe oromandibular dystonia in a child following Japanese encephalitis treated with botulinum toxin

Nepal Journal of Neuroscience ◽

10.3126/njn.v17i1.28345 ◽

2020 ◽

Vol 17 (1) ◽

pp. 53-55

Author(s):

Pradeep Kumar Maurya ◽

Limesh R Vyas ◽

Dinkar Kulshreshtha ◽

Ajai Kumar Singh ◽

Adbul Qavi

Keyword(s):

Quality Of Life ◽

Magnetic Resonance Imaging ◽

Botulinum Toxin ◽

Basal Ganglia ◽

Japanese Encephalitis ◽

Therapeutic Option ◽

Rare Complication ◽

Oromandibular Dystonia ◽

Resonance Imaging

Japanese encephalitis is an important cause of encephalitis in Southeast Asia. Survivors may suffer from various movement disorders leading to disability, presumed to be due to involvement of basal ganglia and thalamus. Oromandibular dystonia is a rare complication of Japanese encephalitis and treatment is unsatisfactory in severe cases. We report a child with JE who developed markedly severe oromandibular dystonia in subacute phase of illness. His Magnetic Resonance Imaging revealed involvement of basal ganglia and thalami. Oral antidystonic medications were used without much avail. In view of severe disabling oromandibular dystonia he was treated with botulinum toxin without adverse effects and had improved quality of life. Botulinum toxin may be considered as a therapeutic option in severe oromandibular dystonia following Japanese encephalitis.

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Effect of botulinum toxin treatment on quality of life in patients with isolated lingual dystonia and oromandibular dystonia affecting the tongue

Journal of Neurology ◽

10.1007/s00415-016-8185-1 ◽

2016 ◽

Vol 263 (9) ◽

pp. 1702-1708 ◽

Cited By ~ 14

Author(s):

Laura Nastasi ◽

Giovanni Mostile ◽

Alessandra Nicoletti ◽

Mario Zappia ◽

Ester Reggio ◽

...

Keyword(s):

Quality Of Life ◽

Botulinum Toxin ◽

Oromandibular Dystonia ◽

Lingual Dystonia ◽

Botulinum Toxin Treatment

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Assessment of health-related quality of life (HRQoL) in patients with spasmodic dysphonia

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20182392 ◽

2018 ◽

Vol 5 (4) ◽

pp. 798

Author(s):

Alok Verma ◽

Babita Gupta ◽

Saurabh Agarwal

Keyword(s):

Quality Of Life ◽

Botulinum Toxin ◽

Spasmodic Dysphonia ◽

New Delhi ◽

Health Related Quality ◽

Moderate Depression ◽

Related Quality ◽

Health Related ◽

Disease Specific

Background: There is paucity of literature regarding health related quality of life in Spasmodic Dysphonia (SD) especially from India. This study assessed HRQoL in it’s global and disease specific aspect by previously validated instruments in patients with SD.Methods: The study was performed in AIIMS, New Delhi. Subjects with SD as well as age and gender matched healthy controls were enrolled from Movement Disorder and botulinum toxin clinic, Department of Neurology, AIIMS, New Delhi. Uneducated patient, those could not read questionnaires & cases who had received botulinum toxin within 6 months were excluded from the study. Each patient filled SF-36, BDI, VoiSS-30 and VPQ questionnaire.Results: 14 pts of Spasmodic Dysphonia (SD) were enrolled. Compared with controls SD patients suffered from statistically significant impaired global health related quality of life (SF36) in areas of role physical (p = 0.007), general health (p = 0.004), social functioning (p = 0.024), role emotion (p = 0.008) and mental health (p=0.039). Patients with SD scored much worse in BDI scale than their control group (12.57±8.0 vs. 4.71±5.0, p=0.005). 65% pt of SD had depression out of whom 14% had moderate depression. SD patient group showed statistically significant impaired scores in disease-specific QOL (VoISS) in 2 out of 3 subscales, impairment (p= <0.001) and emotional (p=<.001) but not in physical (p=0.44). Voice quality of patients with SD was severely affected compared to controls (mean 37± 8.0 vs. 12.9± 1.5).Conclusions: This study clearly demonstrated that patients with SD suffered from significant impairment in HRQoL as compared to controls. Higher proportion of patients with SD suffered from mild to moderate depression compared to their control.

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Botulinum toxin efficacy in the treatment of patients with spasmodic dysphonia

Vojnosanitetski pregled ◽

10.2298/vsp0710671s ◽

2007 ◽

Vol 64 (10) ◽

pp. 671-675

Author(s):

Marina Svetel ◽

Milan Vasic ◽

Gordana Tomic ◽

Predrag Stankovic ◽

Milena Stojanovic ◽

...

Keyword(s):

Quality Of Life ◽

Botulinum Toxin ◽

Diagnostic Procedures ◽

Vocal Folds ◽

Spasmodic Dysphonia ◽

Efficacy Evaluation ◽

Adductor Spasmodic Dysphonia ◽

Botulinum Toxin Therapy ◽

Voice And Speech

Background/Aim. Spasmodic dysphonia (DS) is a disabling speech disturbance appearing as the consequence of dystonic vocal folds contraction. Its intermittent appearance in the laryngeal muscles causes vocal function discontinuation. The quality of life of these patients is significantly disturbed. Surgical and a medical therapy appear to be inadequate and unsuccessful ones of no steady improvement. It is the botulinum toxin therapy that proved to be highly efficacious one, with the established improvement in 80?100% of patients. The aim of our study was to evaluate the efficacy of botulinum toxin therapy in patients with SD and to show our preliminary results. Methods. The study included 10 patients with adductor spasmodic dysphonia. After diagnostic procedures, botulinum toxin was applied either in one or both vocal folds, in doses of 12?16 units each. In our study we applied indirect technique originally developed by Hocevar and Pirtosek. Perceptive voice and speech analysis was performed prior to and after the instillation of botuline toxin as per structured Scale of pathological characteristics of voice and speech appearing in the spasmodic dysphonia. Results. The majority of our patients experienced both subjective improvement and the improvement in the terms of the quality of life, Voice Henolicap Index ? (VHI) that was rated as rather significant one (t = 3.562; p = 0.006). Conclusion. Regardless unquestionable improvement of definite phonation, further function restitution requires individual vocal therapy and psychotherapy. Vocal therapy includes structural vocal techniques which reduce degree of vocal tension and rapid changes in the power and the height of voice. Further investigations are necessary for the scope of the definition of a standardized therapeutically procedure for spasmodic dysphonia treatment which comprises multidisciplinary approach in diagnosis, therapy and treatment efficacy evaluation.

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Self-Rated Communication-Related Quality of Life of Individuals With Oromandibular Dystonia Receiving Botulinum Toxin Injections

American Journal of Speech-Language Pathology ◽

10.1044/2017_ajslp-16-0098 ◽

2017 ◽

Vol 26 (2S) ◽

pp. 674-681 ◽

Cited By ~ 3

Author(s):

Allyson D. Page ◽

Lauren Siegel ◽

Mandar Jog

Keyword(s):

Quality Of Life ◽

Botulinum Toxin ◽

Outcome Measures ◽

Treatment Cycle ◽

Treatment Success ◽

Clinical Population ◽

Oromandibular Dystonia ◽

Patient Reported ◽

Related Quality

Purpose In this preliminary study, we examined self-rated communication-related quality of life (CR-QoL) of 10 control participants and 10 individuals with oromandibular dystonia (OMD) and dysarthria receiving therapeutic botulinum toxin (BoNT-A) injections. Method Participants with OMD and associated dysarthria self-rated CR-QoL pre- and post- BoNT-A injection using the American Speech-Language-Hearing Association's Quality of Communication Life Scale (ASHA QCL; Paul et al., 2004). Control participants self-rated CR-QoL during a single experimental visit. Results Significant differences were found between control participants and participants with OMD on ratings of CR-QoL across all 5 domains and subdomains of the ASHA QCL. No significant differences in CR-QoL were found over the course of the BoNT-A treatment cycle. Conclusions CR-QoL was rated lower by participants with OMD as compared with control participants across all ASHA QCL domains/subdomains with “socialization/activities” and “confidence/self-concept” having the largest effect sizes. No differences in CR-QoL were found over the course of the treatment cycle. We advocate for outcome measures that include patient report. The use of patient-reported outcome measures in conjunction with objective or impairment-based outcome measures can help inform meaningful clinical indicators of treatment success. This study adds novel information that may aid our understanding of the experience of living with OMD in this underserviced clinical population.

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