scholarly journals Localizing Muscles for Botulinum Toxin Treatment of Focal Hand Dystonia

1996 ◽  
Vol 23 (3) ◽  
pp. 194-197 ◽  
Author(s):  
C. Geenen ◽  
E. Consky ◽  
P. Ashby
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Injection ◽  
Treatment Groups ◽  
Focal Hand Dystonia ◽  
Stimulus Current ◽  
Single Target ◽  
Botulinum Toxin Treatment ◽  
Voluntary Contractions ◽  
Hand Dystonia

AbstractBackground: There is currently no consensus on the best way to localize muscles in the forearm for botulinum toxin (BTX) injection. We devised a study to compare electromyography (EMG) with local stimulation through a cannula for localizing forearm muscles for botulinum toxin (BTX) injection, and for predicting the risk of unwanted weakness in non-target muscles. Methods: In 12 patients with focal hand dystonia a single “target” muscle, determined by clinical examination to contribute most to the dystonic hand posture, was selected for botulinum toxin injection. The patients were randomized into 2 treatment groups, one in which the target muscle was localized by recording the EMG signals during voluntary contractions (8 patients) and the other in which the target muscle was localized by local electrical stimulation (4 patients). The target muscle was then injected with a standardized dose of BTX. Results: At follow-up 3 weeks after BTX injection the target muscle was weakened in 7/12 patients (4/8 of the EMG group, and 3/4 of the stimulation group). Additional non-injected muscles, adjacent to the target muscle, were weakened in 5 of these 7 patients, presumably from diffusion of the toxin. Conclusions: Localization by stimulation is probably at least as good as EMG. Each technique has certain advantages. Weakness of “non-target” muscles was not consistently predicted by either EMG or stimulation suggesting that BTX diffuses farther than the volume conduction of EMG signals or the spread of effective stimulus current.

Haptic Feedback Manipulation During Botulinum Toxin Injection Therapy for Focal Hand Dystonia Patients: A Possible New Assistive Strategy

2016 ◽  
Vol 9 (4) ◽  
pp. 523-535 ◽  
Author(s):  
Seyed Farokh Atashzar ◽  
Mahya Shahbazi ◽  
Christopher Ward ◽  
Olivia Samotus ◽  
Mehdi Delrobaei ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Haptic Feedback ◽  
Botulinum Toxin Injection ◽  
Injection Therapy ◽  
Focal Hand Dystonia ◽  
Hand Dystonia

scholarly journals Long-term follow-up of botulinum toxin therapy for focal hand dystonia: Outcome at 10 years or more

2011 ◽  
Vol 26 (4) ◽  
pp. 750-753 ◽  
Author(s):  
Codrin Lungu ◽  
Barbara I. Karp ◽  
Katharine Alter ◽  
Regina Zolbrod ◽  
Mark Hallett
Keyword(s):  
Botulinum Toxin ◽  
Focal Hand Dystonia ◽  
Botulinum Toxin Therapy ◽  
Long Term Follow Up ◽  
Hand Dystonia

Long-term botulinum toxin treatment of focal hand dystonia

Neurology ◽  
1994 ◽  
Vol 44 (1) ◽  
pp. 70-70 ◽  
Author(s):  
B. I. Karp ◽  
R. A. Cole ◽  
L. G. Cohen ◽  
S. Grill ◽  
J. S. Lou ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Focal Hand Dystonia ◽  
Botulinum Toxin Treatment ◽  
Hand Dystonia

scholarly journals Botulinum toxin treatment of salivary fistulas following parotidectomy: follow-up results

2012 ◽  
Vol 17 (4) ◽  
pp. 281-285 ◽  
Author(s):  
Rainer Laskawi ◽  
Jan Winterhoff ◽  
Sabrina Köhler ◽  
Laura Kottwitz ◽  
Christoph Matthias
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Treatment

scholarly journals Long-term Botulinum toxin therapy for focal hand dystonia and reasons for discontinuation

2013 ◽  
Vol 11 (8) ◽  
pp. 657
Author(s):  
Zoltan Mari ◽  
Gopiga Thanabalasundaram ◽  
Eric Farbman ◽  
Barbara Karp ◽  
Mark Hallett
Keyword(s):  
Botulinum Toxin ◽  
Focal Hand Dystonia ◽  
Botulinum Toxin Therapy ◽  
Hand Dystonia

scholarly journals Botulinum Toxin Injection with Conjunctival Microincision for the Treatment of Acute Acquired Comitant Esotropia and Its Effectiveness

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hongjia Xu ◽  
Weifeng Sun ◽  
Shuying Dai ◽  
Yanyan Cheng ◽  
Jing Zhao ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Binocular Vision ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Injection ◽  
Age At Onset ◽  
Brain Magnetic Resonance Imaging ◽  
Significant Difference ◽  
Angle Of Deviation ◽  
The Mean

Purpose. To report on an improved botulinum toxin injection with conjunctival microincision for beginners, and to determine the effectiveness of botulinum toxin A (BTXA) in the treatment of patients with acute acquired comitant esotropia (AACE). Methods. Medical records of 29 AACE patients were retrospectively analyzed. BTXA was injected into the unilateral or bilateral medial rectus muscle with conjunctival microincision without electromyographic guidance. Success was defined as total horizontal deviation ≤10 prism diopters (PD) and evidence of binocular vision. Results. Twenty-nine patients were included, of whom 22 were male and 7 were female. The mean age at onset was 14.2 ± 7.4 (range, 4–34) years. The mean time from onset of AACE to injection was 18.4 ± 20.3 (range, 1–96) weeks. All patients completed at least 6 months of follow-up, and the mean follow-up after BTXA injection was 12.3 ± 4.8 months (range, 7–24 months). Neurological evaluation and brain magnetic resonance imaging (MRI) were unremarkable in all patients. The mean spherical equivalent refraction was −1.22 ± 2.85D and −0.97 ± 2.80D in the right and left eyes, respectively. Mean preinjective esotropia was 38.4 ± 18.9 PD (range, +10–+80 PD) at near and 40.2 ± 17.7 PD (range, +20–+80 PD) at far distance. The mean angle of deviation at 6 months after injection was 0.6 ± 4.1 PD (range, −3–+15 PD) at near and 3.0 ± 5.9 PD (range, 0–+20 PD) at far distance. There was significant difference in the angle of deviation at near and far fixation between pre-BTXA and post-BTXA 6 months ( p < 0.001 , p < 0.001 , resp.). There was no significant difference in the angle of deviation at near and far fixation between post-BTXA 6 months and post-BTXA at final follow-up ( p  = 0.259 and 0.326, resp.). Mean stereoacuity improved from 338 to 88 arc seconds. During the follow-up period, 5 of 29 patients had recurrent esotropia. Two patients refused all further treatment, and the other 3 patients required incisional strabismus surgery. The success rates were 86.2% (25/29) at 6 months and 82.8% (24/29) at final follow-up. Conclusion. Conjunctival microincision injection of botulinum toxin is a practical and safe method for beginners to locate an extraocular muscle, which is as effective as the traditional methods. Botulinum toxin injection can be preferred as the first-line treatment for AACE patients with potential binocular vision.

A Combination of Constraint-Induced Therapy and Motor Control Retraining in the Treatment of Focal Hand Dystonia in Musicians: A Long-term Follow-up Study

2013 ◽  
Vol 28 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Patrice Berque ◽  
Heather Gray ◽  
Angus McFadyen
Keyword(s):  
Motor Control ◽  
Repeated Measures ◽  
Motor Disorder ◽  
Long Term Effects ◽  
Focal Hand Dystonia ◽  
Repeated Measures Design ◽  
Abnormal Movements ◽  
Hand Dystonia

Focal hand dystonia (FHD) in musicians is a painless, task-specific motor disorder characterized by involuntary loss of control of individual finger movements. The aim of this study was to investigate the long-term effects of a combined behavioral therapy intervention aimed at normalizing finger movement patterns. METHODS: Eight musicians with FHD had taken part in the 1-year study involving intensive constraint-induced therapy and motor control retraining at slow speed as the interventions. Four of these subjects volunteered to take part in this 4-year follow-up. A quasi-experimental, repeated measures design was used, with 9 testing sessions over 4 years. Video recordings of the subjects playing two pieces were used for data analysis. The Frequency of Abnormal Movements scale (FAM) was the main outcome measure. It was hypothesized that there would be significant differences in FAM scores achieved over the 4-year period. RESULTS: The results from the ANOVA revealed a significant decrease, by approximately 80%, in the number of abnormal movements for both pieces over the 4-year period (F=7.85, df=8, p<0.001). Tukey’s post-hoc test revealed that significant improvements occurred after 6 months of therapy (p-values between p<0.001 and p=0.044). Although the results were not significant between month 12 and follow-up at year 4, the trend revealed that the progress achieved during the first year of intensive retraining was maintained at year 4. CONCLUSIONS: A 1-year period of intensive task-specific retraining may be a successful strategy with long-term, lasting effects for the treatment of musician’s FHD. Results suggest that retraining strategies may need to be carried out for at least 6 months before statistically significant changes are noted.

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