Background/Aim. Botulinum toxin (BTX) irreversibly inhibits presynaptic
acetylcholine release with subsequent relaxation of abnormally contracting
muscles. It is an effective and well tolerated treatment with long-term
benefit in a variety of movement disorders and other neurological and
non-neurological disturbances. The aim of our study was to present our
experience with BTX type A in treatment of different forms of focal
dystonias. ?ethods. ? hundred of patients with different focal dystonias
(spastic torticollis, blepharospasm and graphospasm) from the Botulinum Toxin
Outpatients Department, Clinic for Neurology, Clinical Center of Serbia, were
included in the study. All the patients were examined and rated at baseline
visit prior to BTX application and on the following visit, after 3-4 months,
using self-assessment improvement questionnaire and standardized rating
scales. Results. The improvement of ? 50% was presented in 68.2% of all (199)
the analyzed applications. Independent predictors of good response to the
therapy (improvement ? 50%) were male sex (p = 0.011), the presence of
sensory trick (p = 0.013) and the total number of BTX applications (p =
0.002). The patients with spastic torticollis and blepharospasm showed a
statistically significantly better BTX effect (improvement 57.3 ? 27.5% and
54.1 ? 28.3%), respectively than the graphospasm group (26.7 ? 25.6%). Most
of the patients did not have therapy complications (81.4% and 72% in two
applications). Side effects in the remaining patients (muscle weakness,
dysphagia, ptosis, double vision, neck weakness and lacrimal dysfunction)
lasted for 28.3 ? 18.6 days after the first treatment and 32.5 ? 36.2 days
after the second one. Conclusion. BTX is safe and highly effective in
long-term treatment of patients with different forms of focal dystonia, with
only mild and well-tolerated side-effects.
Efficacy of Botulinum toxin type A in treatment of different forms of focal dystonias in the Serbian population: Experience of the Botulinum Toxin Outpatients Department