The efficacy of botulinum toxin type-A for intractable chronic migraine patients with no pain-free time

2021 ◽  
pp. 204946372110145
Author(s):  
Dominic Atraszkiewicz ◽  
Rieko Ito ◽  
Anish Bahra
Keyword(s):  
Botulinum Toxin ◽  
Chronic Migraine ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Free Time ◽  
Phase Iii ◽  
Pharmacological Management ◽  
Sustained Reduction ◽  
New Onset

Aim: This is a retrospective report of the efficacy of botulinum toxin-A, Botox® (Allergan), in intractable chronic migraine patients non-responsive to previous pharmacological management and with largely no pain-free time, including those with new onset daily persistent headache. Methods: Thirty-three patients, all with severe Headache Impact Test (HIT)-6 scores at baseline, received 3-monthly injections of Botox® as per Phase III REsearch Evaluating Migraine Prophylaxis Therapy (PRE-EMPT) protocol over a maximum 33-month period. Response criteria were a sustained reduction of HIT-6 scores below 60. Results: Four patients had headache on at least 20 days a month; the remaining patients had daily headache with no pain-free time, including nine patients with new onset persistent migraine. There was a significant reduction in HIT-6 scores following Botox® therapy ( x̅ = −5.45, p = 0.000920). Twenty-one percent of the cohort exhibited a sustained reduction in HIT-6 scores below 60. The number of headache days and pain-free time did not change in five of the six responders, but disability improved. There was no difference between patients with episodic migraine evolving to chronic as opposed to those with chronic migraine from onset. Conclusion: This report suggests that Botox® treatment is efficacious in intractable chronic migraine without pain-free time. The HIT-6 is a reliable and practical parameter to assess disability in this patient group. Use of such validated parameters should be considered with greater weight in future International Classification of Headache Disorders (ICHD) guidelines for controlled clinical trials.

Lingual Dystonia Treated with Botulinum Toxin - A Case Report

1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
X Ray ◽  
Medical College ◽  
Lingual Dystonia ◽  
History Of ◽  
Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

scholarly journals Botulinum toxin A in the treatment of blepharospasm: a 10-year experience

2005 ◽  
Vol 63 (2a) ◽  
pp. 221-224 ◽  
Author(s):  
Laura Silveira-Moriyama ◽  
Lilian R. Gonçalves ◽  
Hsin Fen Chien ◽  
Egberto R. Barbosa
Keyword(s):  
Botulinum Toxin ◽  
Adverse Effects ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Term Effect ◽  
Secondary Resistance ◽  
School Of Medicine ◽  
Long Term Effect

To evaluate the long-term effect of botulinum toxin type A (BTX) in the treatment of blepharospasm, a retrospective analysis was conducted from the patients seen at the Movement Disorders Clinic of the Department of Neurology, Hospital das Clínicas, University of São Paulo School of Medicine from 1993 to 2003. A total of 379 treatments with BTX were administered to 30 patients with blepharospasm. Sixty six per cent of the subjects had used oral medication for dystonia and only 15% of them reported satisfactory response to this treatment. Ninety three per cent of the patients showed significant improvement after the first BTX injection. There was no decrement in response when compared the first and the last injection recorded. Adverse effects, mostly minor, developed at least once in 53% of patients. Six patients (20%) discontinued the treatment but there was no case of secondary resistance.

Botulinum toxin A injection into corrugator muscle for frontally localised chronic daily headache or chronic tension-type headache

2008 ◽  
Vol 123 (4) ◽  
pp. 412-417 ◽  
Author(s):  
J A de Ru ◽  
J Buwalda
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Injection ◽  
Botulinum Toxin Type A ◽  
Effective Means ◽  
Case Series ◽  
Botulinum Toxin Type ◽  
Toxin A ◽  
Tertiary Referral Centre ◽  
Corrugator Supercilii

AbstractObjective:To describe our results with botulinum toxin type A injection for headache in carefully selected patients, and to present the rationale behind this therapy.Setting:Tertiary referral centre.Patients and methods:This article describes a case series of 10 consecutive patients with frontally localised headache, whose pain worsened when pressure was applied at the orbital rim near the supratrochlear nerve. The patients received a local anaesthetic nerve block with Xylocaine 2 per cent at this site. If this reduced the pain, they were then offered treatment with botulinum toxin.Intervention:Injection with 12.5 IU of botulinum toxin A into the corrugator supercilii muscle on both sides (a total of 25 IU).Main outcome measure:Pain severity scoring by the patients, ranging from zero (no pain) to 10 (severe pain) on a verbal scale.Results:Following injection, all patients had less pain for approximately two months. This treatment did not appear to have lasting side effects.Conclusion:Xylocaine injection is a good predictor of the effectiveness of botulinum toxin injection into the corrugator muscle as treatment of frontally localised headache. We hypothesise that this pain is caused by entrapment of the supratrochlearis nerve in the corrugator muscle. Furthermore, we found botulinum toxin injection to be a safe and effective means of achieving pain relief in this patient group.

scholarly journals Botulinum Toxin in the Treatment of Headache

Toxins ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 803
Author(s):  
Werner J. Becker
Keyword(s):  
Botulinum Toxin ◽  
Chronic Migraine ◽  
Mechanism Of Action ◽  
Recombinant Dna ◽  
Botulinum Toxin Type A ◽  
Preventive Treatment ◽  
Botulinum Toxin Type ◽  
Preventive Therapy ◽  
Ongoing Research ◽  
Recombinant Dna Techniques

Botulinum toxin type A has been used in the treatment of chronic migraine for over a decade and has become established as a well-tolerated option for the preventive therapy of chronic migraine. Ongoing research is gradually shedding light on its mechanism of action in migraine prevention. Given that its mechanism of action is quite different from that of the new monoclonal antibodies directed against calcitonin gene-related peptide (CGRP) or its receptor, it is unlikely to be displaced to any major extent by them. Both will likely remain as important tools for patients with chronic migraine and the clinicians assisting them. New types of botulinum toxin selective for sensory pain neurons may well be discovered or produced by recombinant DNA techniques in the coming decade, and this may greatly enhance its therapeutic usefulness. This review summarizes the evolution of botulinum toxin use in headache management over the past several decades and its role in the preventive treatment of chronic migraine and other headache disorders.

Chronic migraine and Botulinum Toxin Type A: Where do paths cross?

Toxicon ◽  
2020 ◽  
Vol 178 ◽  
pp. 69-76
Author(s):  
Daniele Martinelli ◽  
Sebastiano Arceri ◽  
Livio Tronconi ◽  
Cristina Tassorelli
Keyword(s):  
Botulinum Toxin ◽  
Chronic Migraine ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type

scholarly journals Botulinum Toxin A: A Novel Adjunct Treatment for Debilitating Habit Cough in Children

2007 ◽  
Vol 86 (9) ◽  
pp. 570-572 ◽  
Author(s):  
J. Andrew Sipp ◽  
Kennan E. Haver ◽  
Bruce J. Masek ◽  
Christopher J. Hartnick
Keyword(s):  
Botulinum Toxin ◽  
Mental Health Professionals ◽  
Vocal Fold ◽  
Behavioral Therapy ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Adjunct Treatment ◽  
Vocal Fold Injection ◽  
Habit Cough

Vocal fold injection with botulinum toxin type A (BTX-A) may be used as an adjunct treatment for habit cough in children. We conducted a retrospective review of 3 cases involving children aged 11 to 13 years with habit cough treated with vocal fold injection of BTX-A. Injections of BTX-A to the thyroarytenoid muscles were effective in breaking the cough cycle in all 3 children. Their coughs recurred but were controlled with 4 to 8 sessions of behavioral therapy. Behavioral therapy remains the first-line treatment, but BTX-A may be a useful complement to behavioral therapy in patients who fail standard treatments or in those with severe cough who have limited or delayed access to mental health professionals. This is the first report, to our knowledge, on the use of BTX-A in the treatment of a habit cough.

scholarly journals Successful treatment of lower eyelid epiblepharon by injection of botulinum toxin A in patients under two years of age

2013 ◽  
Vol 5 (2) ◽  
pp. 177-181 ◽  
Author(s):  
CY Chen ◽  
Angel Nava-Castaneda
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Lower Eyelid ◽  
Rank Test ◽  
Orbicularis Muscle

Introduction: Epiblepharon is characterized by a cutaneous horizontal fold adjacent to the lid margin. Some cases showed spontaneous resolution, others required surgical treatment. We propose a medical treatment with botulinum toxin type A (BTX-A). Objective: To provide clinical evidence of the usefulness of botulinum toxin type A (BTX-A) in patients with lower eyelid epiblepharon. Subjects and methods: This was a prospective, non-randomized, nonmasked study. Patients with lower eyelid epiblepharon with corneal eyelash contact were included in the study. The scale proposed by Khwarg & Lee (1997) was used to assess the epiblepharon clinical evaluation. A single dose of 12.5 IU of BTX-A (Dysport ®) was directly injected into the medial pre-tarsal orbicularis muscle region in the lower eyelid. Patients were evaluated before the injection and at 1, 4, 12 and 24 weeks after the injection. We performed descriptive statistics and Wilcoxon Signed Rank Test, comparing prior injection measurements to post injection measurements at the 24th week. A p < 0.05 was considered statistically significant. Each eye was separately analyzed. Results: Fourteen eyes of seven Hispanic patients were treated, five female and two male. The mean age was 8.4 months (4 - 14 months). The height of the skin-fold, the area of the cornea touched by the cilia and the symptoms score improved after the first week of BTX-A injection and remained so until the end of study (p < 0.05). No major complications were noted. Conclusion: The effect of a single 12.5 IU injection of BTX-A (Dysport ®) into the medial orbicularis muscle portion in the lower eyelid epiblepharon patients successfully improves the clinical signs and symptoms. Nepal J Ophthalmol 2013; 5(10): 177-181 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8709

scholarly journals Botulinum toxin type A and cervical dystonia: a seven-year follow-up

2011 ◽  
Vol 69 (5) ◽  
pp. 745-750 ◽  
Author(s):  
Carlos Henrique F. Camargo ◽  
Hélio Afonso G. Teive ◽  
Nilson Becker ◽  
Renato P. Munhoz ◽  
Lineu César Werneck
Keyword(s):  
Botulinum Toxin ◽  
Cervical Dystonia ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Clinical Severity ◽  
Term Therapy ◽  
Regular Treatment

Most cases of cervical dystonia (CD) are idiopathic, and focal injections of botulinum toxin A (BoNT/A) are the treatment of choice. The objective of our study was to document the effects of long-term BoNT/A treatment in idiopathic CD patients. Fifty-eight patients with idiopathic CD were recruited from March 2001 to May 2002. Twenty-eight of the subjects were available for reassessment after seven years. During this period, all had received regular treatment with BoNT/A injections. Clinical information about patients and the severity of CD (TWSTRS and VAPS) at baseline assessment (2001-2002) and follow-up (2008-2009) was compared. Significant motor improvement was detected based on TWSTRS scale scores, which were used to analyze clinical severity (19.6±6.6 and 17.7±4.8; p<0.05). There was no improvement in the severity of cervical pain (p=0.43). In conclusion, BoNT/A was a safe and effective long-term therapy for CD.

Botulinum Toxin Type-A Toxinactivity in Prostate Cancer Cell Lines

2012 ◽  
Vol 79 (2) ◽  
pp. 135-141 ◽  
Author(s):  
Silvia Proietti ◽  
Vincenza Nardicchi ◽  
Massimo Porena ◽  
Antonella Giannantoni
Keyword(s):  
Prostate Cancer ◽  
Botulinum Toxin ◽  
Cell Growth ◽  
Cell Lines ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Prostatic Epithelium ◽  
Apoptotic Activity ◽  
Few Data

Aim of the study Botulinum toxin A (BoNT/A) has been recently used in the treatment of benign prostatic hyperplasia due to its apoptotic activity on prostatic epithelium but few data exist on this issue in prostate cancer. Also no information exist on the eventual modulation exerted by the neurotoxin on Phospholipase A2 (PLA2) expression in prostate cancer. The aim of this study was to evaluate the activity of BoNT/A on cell growth and expression of PLA2 in prostate cancer lines. Materials and Methods PC-3 and LNCaP cell lines were exposed to BoNT/A (Xeomin®), different doses and time of exposure. Presence of SV2 receptors (SV2-A and SV2-B) for the neurotoxin was also investigated. The expression of P-Ser505-cPLA2-α (phosphorylated enzyme) was performed immunofluorescence. Results After 96 hours of BoNT/A administration a 20% reduction of cell growth in LNCaP and 25% in PC-3 were observed. SV-2 receptors were expressed in both cell lines. No cPLA2–α total expression was found in LnCaP. In PC-3 there was a high expression of cPLA2–α total which was not modified after BoNT/A treatment. In both LNCap and PC-3 the expression of P-Ser505-cPLA2-α (phosphorylated enzyme) increases significantly after treatment with [10 U/ml] of BoNT/A. Conclusions LNCaP and PC-3 cell lines are sensitive to treatment with BoNT/A which probably enters the cells by SV2 receptors. The increase in the phosphorylated form of cPLA2-a, induced by BoNT/A may represent one mechanism by which the toxin reduces cell growth and proliferation.

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