Videonystagmography as a tool to assess blepharospasm before and after botulinum toxin injection

Abstract Background The treatment efficacy of botulinum toxin bilateral medial rectus injections for acute acquired concomitant esotropia (AACE) in adult is not clear. We characterize the effects of botulinum toxin injection in the treatment of AACE, especially in patients over 14 years old, and compared it with surgical treatment. Methods In this prospective, nonrandomized, controlled clinical study, patients with AACE in our hospital from March 2017 to March 2020 elected to receive bilateral medial rectus injections of botulinum toxin or to undergo extraocular muscle surgery. Ocular position and stereopsis were evaluated before and after treatment. Results A total of 60 patients were treated: 40 patients in the botulinum toxin group, and 20 patients in the surgery group. The botulinum toxin group included 31 cases ≥ 14 years of age and 9 cases < 14 years of age. After 1–3 botulinum injections, the cumulative initial success rate was 95% (38/40), and the recurrence rate was 22.5% (9/40). Nine children < 14 years of age were treated successfully, without recurrence. In the surgery group, the initial success rate after surgery was 75% (17/20), and the recurrence rate was 20% (4/20). There was no significant difference between groups in the rate of success rate or the rate of recurrence (P > 0.05). Conclusion The injection of botulinum toxin has a good effect on AACE in adults and children. The outcomes achieved with injected botulinum toxin are similar to those achieved with surgery. Trial registration ChiCTR, ChiCTR2000032544. Registered May 2, 2020, Retrospectively registered.

Download Full-text

Treatment of Acute Acquired Concomitant Esotropia

10.21203/rs.3.rs-94486/v1 ◽

2020 ◽

Author(s):

Minghua Shi ◽

Yuanxiang Zhou ◽

Aijiao Qin ◽

Jing Chen ◽

Hongxing Ren

Keyword(s):

Botulinum Toxin ◽

Success Rate ◽

Recurrence Rate ◽

Botulinum Toxin Injection ◽

Medial Rectus ◽

Good Effect ◽

Surgery Group ◽

Significant Difference ◽

Before And After ◽

Initial Success Rate

Abstract Background: The treatment efficacy of botulinum toxin bilateral medial rectus injections for acute acquired concomitant esotropia (AACE) in adult is not clear. We characterize the effects of botulinum toxin injection in the treatment of AACE, especially in patients over 14 years old,and compared it with surgical treatment.Methods: In this prospective, nonrandomized, controlled clinical study, patients with AACE in our hospital from March 2017 to March 2020 elected to receive bilateral medial rectus injections of botulinum toxin or to undergo extraocular muscle surgery. Ocular position and stereopsis were evaluated before and after treatment.Results: A total of 60 patients were treated: 40 patients in the botulinum toxin group, and 20 patients in the surgery group. The botulinum toxin group included 31 cases ≥14 years of age and 9 cases <14 years of age. After 1–3 botulinum injections, the cumulative initial success rate was 95% (38/40), and the recurrence rate was 22.5% (9/40). Nine children <14 years of age were treated successfully, without recurrence. In the surgery group, the initial success rate after surgery was 75% (17/20), and the recurrence rate was 20% (4/20). There was no significant difference between groups in the rate of success rate or the rate of recurrence (P>0.05).Conclusion: The injection of botulinum toxin has a good effect on AACE in adults with minimal squinting and in children. The outcomes achieved with injected botulinum toxin are similar to those achieved with surgery.Trial registration: ChiCTR, ChiCTR2000032544. Registered May 2, 2020，Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=52349

Download Full-text

Treatment of Dysfunction of the Cricopharyngeal Muscle with Botulinum a Toxin: Introduction of a New, Noninvasive Method

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949410300105 ◽

1994 ◽

Vol 103 (1) ◽

pp. 31-35 ◽

Cited By ~ 165

Author(s):

Imma Schneider ◽

Claus Pototschnig ◽

Walter F. Thumfart ◽

Hans E. Eckel

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin A ◽

Botulinum Toxin Injection ◽

Upper Esophageal Sphincter ◽

Intraluminal Pressure ◽

Complete Relief ◽

Cricopharyngeal Muscle ◽

Before And After ◽

Preoperative Diagnostic ◽

Disability Rating

Botulinum toxin is known as a relatively safe and efficacious agent for the treatment of various neurologic and ophthalmologic disorders. Since dysphagia and deglutition problems combined with aspiration are often caused by spasticity, hypertonus, or delayed relaxation of the upper esophageal sphincter (UES), conventional treatment including lateral cricopharyngotomy was replaced by localized injections of botulinum toxin into the cricopharyngeal muscle (CM) in a series of 7 patients. The study comprised patients with slight dysphagia caused by isolated hypertonus of the UES, as well as patients with severe deglutition disorders, complete inability to swallow, and aspiration problems. Preoperative diagnostic evaluation included careful history-taking, physical examination, cineradiography, and esophageal manometry to exclude other causes of dysphagia. For precise localization, injections were performed under general anesthesia after location of the CM by direct esophagoscopy and electromyographic guidance. Injections were administered into the dorsomedial part and on both sides into the ventrolateral parts of the muscle. Depending on the severity of symptoms and the intraluminal pressure of the UES, the dose varied between 80 and 120 units (botulinum toxin A from Dysport). The treatment outcome was evaluated by a disability rating score: patients' complaints were scored by subjective and objective parameters before and after injection. All but 2 patients experienced complete relief or marked improvement of their complaints. There were no severe side effects or postoperative complications. Local botulinum toxin injection proved to be an effective alternative treatment to invasive procedures for patients with isolated dysfunction of the UES, and also for patients with more complex deglutition problems combined with aspiration.

Download Full-text

Comparison of lower limb joint powers in cerebral palsy before and after botulinum toxin injection

Gait & Posture ◽

10.1016/j.gaitpost.2009.08.136 ◽

2009 ◽

Vol 30 ◽

pp. S91

Author(s):

Sanjay Kapoor ◽

Sheila Gibbs ◽

Rami Abboud ◽

Weijie Wang

Keyword(s):

Cerebral Palsy ◽

Botulinum Toxin ◽

Lower Limb ◽

Botulinum Toxin Injection ◽

Before And After

Download Full-text

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.

Download Full-text

Effects of Botulinum Toxin on Pathophysiology in Spasmodic Dysphonia

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940010900215 ◽

2000 ◽

Vol 109 (2) ◽

pp. 194-203 ◽

Cited By ~ 63

Author(s):

Steven Bielamowicz ◽

Christy L. Ludlow

Keyword(s):

Botulinum Toxin ◽

Muscle Activity ◽

Muscle Activation ◽

Botulinum Toxin Injection ◽

Symptom Relief ◽

Spasmodic Dysphonia ◽

Laryngeal Muscle ◽

Adductor Spasmodic Dysphonia ◽

Before And After ◽

Thyroarytenoid Muscle

To determine the mechanism of symptom relief with treatment by botulinum toxin injection in persons with adductor spasmodic dysphonia (ADSD), we evaluated the effects of unilateral thyroarytenoid muscle injections on both injected and noninjected muscles in 10 subjects with ADSD, using electromyography on both sides of the larynx before and after treatment. The subjects' speech symptoms were reduced (p = .005) 2 weeks following injection, when the electromyographic study occurred. Muscle activation levels and the numbers of spasmodic muscle bursts decreased significantly (p ≤ .03) postinjection in both the injected and noninjected muscles. The reductions in laryngeal muscle bursts correlated with symptom reduction (r ≥ .7) in all muscles. Reductions in laryngeal muscle bursts did not relate to either absolute or normalized levels of muscle activity before or after botulinum toxin injection. The results suggest that changes in the central pathophysiology are responsible for changes in speech symptoms following treatment.

Download Full-text

Objective assessment of cortical activity changes in stroke patients before and after hand rehabilitation with and without botulinum toxin injection

Egyptian Rheumatology and Rehabilitation ◽

10.4103/err.err_38_16 ◽

2017 ◽

Vol 44 (4) ◽

pp. 172

Author(s):

OmniaA Abu-Bakr ◽

NagwaaM.M Nassar ◽

AmalM Al-Ganzoury ◽

KhaledAbo-Elfotouh Ahmed ◽

EmanA Tawfik

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin Injection ◽

Objective Assessment ◽

Cortical Activity ◽

Hand Rehabilitation ◽

Stroke Patients ◽

Before And After

Download Full-text

Comparison of botulinum toxin with surgery for the treatment of acute acquired comitant esotropia and its clinical characteristics

Scientific Reports ◽

10.1038/s41598-019-50383-x ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Li-juan Lang ◽

Yu Zhu ◽

Zhi-gang Li ◽

Guang-ying Zheng ◽

Hai-ying Peng ◽

...

Keyword(s):

Botulinum Toxin ◽

Success Rate ◽

Clinical Characteristics ◽

Botulinum Toxin Injection ◽

Post Treatment ◽

Therapeutic Effects ◽

Deviation Angle ◽

Before And After ◽

Pre Treatment ◽

Group B

Abstract We compared the therapeutic effects between botulinum toxin and surgery for acute acquired comitant esotropia (AACE) and analyze its clinical characteristics. The data of the 29 cases, who received treatment for AACE in the Ophthalmic Center of the First Affiliated Hospital of Zhengzhou University and Henan Provincial Ophthalmology Hospital between January 2016 and January 2017, were collected. The 29 cases with AACE were followed for 6 months or more, and received either botulinum toxin injection (group A with 13 cases) or squint correction (group B with 16 cases). The distant and near deviation angles were compared between the two groups before and after treatment. The success rate (total horizontal deviation of 10 prism diopters or less) and stereopsis were compared between the two groups at post-treatment 6 months. At the same time, the relations between distant and near deviation angles were analyzed among different myopia levels and different AACE types. Results indicated that he success rate was not significantly different at post-treatment 6 months (84.6% vs 81.3%, P = 1.00). The distant and near deviation angles were all significantly different one day and one month after treatment (all P < 0.05); but at post-treatment 6 months, they were not significantly different (all P > 0.05) between the two groups. There were no significant differences in the distant and near stereoacuity between the two groups at post-treatment 6 months (all P > 0.05). Among the 25 cases with myopia, the pre-treatment distant deviation angle was significantly higher than pre-treatment near deviation angle in the cases with myopia level >−2.5 D (P < 0.05), and the pre-treatment distant and near deviation angles were all significantly higher in the cases with type-IIAACE than in the cases with type-IIIAACE (all P < 0.05). This study suggests that Botulinum toxin is as effective as surgery in the treatment of AACE at post-treatment 6 months. For the cases with myopia level >−2.5 D, the pre-treatment distant deviation angle is significantly higher than pre-treatment near deviation angle; and both pre-treatment distant and near deviation angles are greater in the cases with type-IIAACE than in the cases with type-IIIAACE.

Download Full-text