Effective botulinum toxin injection guide for treatment of cervical dystonia

Cervical dystonia, which is the most common form of focal dystonia, presents with sustained neck spasms, abnormal head posture, head tremor, and pain. One of the interesting and unique features of cervical dystonia is the geste antagoniste. There is not a well-described pathophysiology for cervical dystonia, but several hypotheses report involvement at the central and peripheral level. Treatment options include: oral medical therapy, botulinum toxin injection, and surgery. Oral medical therapy has limited efficacy in control of the symptoms of cervical dystonia. Two types of botulinum toxin, types A and B, are being used for treatment of cervical dystonia, with equivalent benefit. Surgery is an option when other treatments fail or become ineffective. The surgical procedures are brain lesioning, brain stimulation, and peripheral surgical intervention. Several trials are currently ongoing in the United States and Europe to evaluate the efficacy of deep brain surgery in cervical dystonia.

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P66 Should we be screening for depression and quality of life in all patients attending botulinum toxin injection clinics or just those with cervical dystonia?

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-abn.128 ◽

2019 ◽

Vol 90 (3) ◽

pp. e40.1-e40

Author(s):

R Mozdiak ◽

R Lally ◽

F Osei-Poku ◽

J Alty

Keyword(s):

Quality Of Life ◽

Botulinum Toxin ◽

Pilot Study ◽

Cervical Dystonia ◽

Botulinum Toxin Injection ◽

Cross Sectional ◽

Female Age ◽

Meige Syndrome ◽

Prevalence Of Depression

ObjectivesCervical dystonia (CD) is known to be associated with depression and low quality of life (QoL) but we know little about these measures in non-CD patients attending botulinum toxin clinics. The objective was to evaluate the prevalence of depression and low QoL in both CD and nonCD patients.DesignCross-sectional pilot study.SubjectsConsecutive patients attending teaching hospital botulinum toxin clinic.MethodsPatients completed the Beck’s Depression Inventory (BDI) questionnaire and a Recovering Quality of Life (ReQoL) scale. BDI and ReQoL scores of ≥17 and≤24 indicated depression and impaired QoL respectively.Results48 patients (30 female; age 45–75 years) were evaluated; 33:15 CD:non-CD. The non-CD group comprised hemifacial spasm, upper limb dystonia/tremor, blepharospasm and Meige syndrome. 23% (11/48) of all patients had depression: 27% (9/33) of CD and 13% (2/15) of non-CD. Depression rates were more frequent amongst females and males (27%; 17%) (p=0.43). 34% of all patients had low QoL – 36% (12/33) and 27% (4/15) in the CD and non-CD groups respectively (p=0.51). Low QoL scores were more frequent in females (40%) than males (22%) but this difference was not significant (p=0.21).ConclusionsDepression and low quality of life were common in all patients in this pilot study. This suggests that screening of all patients attending botulinum toxin clinics, regardless of their diagnosis, may be clinically important. A larger study is required to validate these findings.

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Cervical Dystonia and Executive Function: A Pilot Magnetoencephalography Study

Brain Sciences ◽

10.3390/brainsci8090159 ◽

2018 ◽

Vol 8 (9) ◽

pp. 159 ◽

Cited By ~ 2

Author(s):

Abhimanyu Mahajan ◽

Andrew Zillgitt ◽

Abdullah Alshammaa ◽

Neepa Patel ◽

Christos Sidiropoulos ◽

...

Keyword(s):

Executive Function ◽

Botulinum Toxin ◽

Cervical Dystonia ◽

Botulinum Toxin Injection ◽

Neuropsychological Testing ◽

Network Connectivity ◽

Brain Regions ◽

Continuous Performance Task ◽

Source Imaging ◽

Before And After

Background: Cervical dystonia (CD) patients have impaired working memory, processing speed and visual-motor integration ability. We used magnetoencephalography (MEG) to investigate changes in cerebral oscillations in CD patients during an executive function test, before and after administration of botulinum toxin. Methods: MEG data were collected from five CD patients while they performed a visual continuous performance task (CPT), before and after they received a botulinum toxin injection. MEG data was also collected on five controls matched for age and gender. Coherence source imaging was performed to quantify network connectivity of subjects. Results: Controls demonstrated two errors with visual CPT; CD patients demonstrated six and three errors pre- and post-botulinum toxin respectively. After botulinum toxin, mean time from cue to correct response was 0.337 s in controls, 0.390 s in patients before botulinum toxin injection, and 0.366 s after the injection. Differences in coherence between controls and patients were found in the following brain regions: Fronto-frontal, fronto-parietal, fronto-striatal, fronto-occipital, parieto-parietal and temporo-parietal. Intrahemispheric and interhemispheric networks were affected. Post injection, there was minimal change in coherence in the above-mentioned networks. Discussion: Neuropsychological testing suggests difference in coherence in frontal circuits between CD cases and controls during the visual CPT, which may reflect subjects’ increased difficulty with the task. Botulinum toxin is associated with minimal improvement with executive function in CD.

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Occurrence of Dysphagia Following Botulinum Toxin Injection in Parkinsonism-related Cervical Dystonia: A Retrospective Study

Tremor and Other Hyperkinetic Movements ◽

10.5334/tohm.285 ◽

2016 ◽

Vol 6 (0) ◽

pp. 379 ◽

Cited By ~ 1

Author(s):

Addie Patterson ◽

Leonardo Almeida ◽

Christopher W. Hess ◽

Daniel Martinez-Ramirez ◽

Michael S. Okun ◽

...

Keyword(s):

Retrospective Study ◽

Botulinum Toxin ◽

Cervical Dystonia ◽

Botulinum Toxin Injection

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Non-motor disorders in cervical dystonia

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2018-3-135-140 ◽

2018 ◽

Vol 10 (3) ◽

pp. 135-140 ◽

Cited By ~ 1

Author(s):

V. A. Tolmacheva ◽

M. R. Nodel ◽

N. I. Saloukhna

Keyword(s):

Quality Of Life ◽

Botulinum Toxin ◽

Mental Disorders ◽

Cervical Dystonia ◽

Botulinum Toxin Injection ◽

Injection Therapy ◽

Motor Disorders ◽

Improve Quality ◽

Perceptual Disorders

Botulinum toxin injection therapy is the mainstay for managing patients with motor manifestations of dystonia. It is important to identify possible cognitive and mental disorders, sleep and perceptual disorders (non-motor disorders) in these patients. Correction of these disorders will be able to optimize treatment and to improve quality of life of patients.

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Experiences on the administration of botulinum toxin in movement disorders

Journal of Translational Internal Medicine ◽

10.2478/jtim-2021-0003 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Buket Tuğan Yıldız ◽

Deniz Tuncel Berktaş

Keyword(s):

Botulinum Toxin ◽

Side Effects ◽

Cervical Dystonia ◽

Botulinum Toxin Injection ◽

Wide Range ◽

Generalized Dystonia ◽

Duration Of Efficacy ◽

Botulinum Toxin Treatment ◽

Botulinum Toxin Injections ◽

Made In

AbstractBackground and objectivesBotulinum toxin injection has been used for many years for various indications such as cervical dystonia, blepharospasm, oromandibular dystonia, hemifacial spasm in neurology. Botulinum toxin injections have been made in our clinic for about ten years. We want to report our experiences about botulinum toxin treatment in neurologic disease.MethodsIn this study, the data of the patients receiving BoNT injection between January 2018 and December 2019 was retrospectively analyzed. Age, gender, botulinum toxin indications, and mean dose, duration of efficacy, side effects noted for each injection were recorded.ResultsThere were 122 patients who received botulinum toxin injections between January 2018 and December 2019. Of the 122 patients identified, 28 had cervical dystonia, 61 had HFS, 21 had blepharospasm, 4 had generalized dystonia, 1 had hemidystonia following thalamic bleeding, 1 had tardive dystonia, 4 had migraine, 1 had bruxism and 1 had both migraine and bruxism.ConclusionBoNT injection is a treatment that has been used for various indications in neurology for almost 40 years. Side effects are limited and temporary with appropriate injections. We also had a wide range of indication profiles and high numbers of patients to whom we administered the BoNT treatment.

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