Experiences on the administration of botulinum toxin in movement disorders

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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Effectiveness of Acupuncture in Cervical Dystonia

Acupuncture in Medicine ◽

10.1136/aim.2009.002048 ◽

2010 ◽

Vol 28 (2) ◽

pp. 94-96 ◽

Cited By ~ 3

Author(s):

Ravindran Deepak ◽

Hans Mathew ◽

Mathew Koshy

Keyword(s):

Botulinum Toxin ◽

Side Effects ◽

Cervical Dystonia ◽

Muscle Tone ◽

Muscle Spasm ◽

Treatment Combination ◽

First Case ◽

Botulinum Toxin Injections

This case describes the successful addition of acupuncture to treat a patient with cervical dystonia previously managed with Botox (botulinum toxin) injections. This resulted in reduced pain and muscle spasm relief and to the authors’ knowledge is the first case to be reported using this treatment combination. The patient was diagnosed with the idiopathic variant of cervical dystonia and had been treated with regular Botox injections for almost a year and half. She was then referred for a course of acupuncture to manage pain and reduce excessive muscle tone. She had excellent benefit from the acupuncture and she continued to get top-ups of acupuncture every 8–10 weeks. Requirement for Botox injections had decreased thus reducing its long-term side effects.

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Hereditary geniospasm in a mother and son treated with botulinum toxin injection: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x21993593 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2199359

Author(s):

Clare Perkins ◽

Wei Jia ◽

James Rainsbury ◽

Andrew Lux

Keyword(s):

Case Report ◽

Botulinum Toxin ◽

Side Effects ◽

Beta Blockers ◽

Botulinum Toxin Injection ◽

Treatment Options ◽

Benign Disorder ◽

The World ◽

Botulinum Toxin Injections

Hereditary geniospasm is a rare and benign disorder that can cause distress and social embarrassment to patients. There are only a handful of possible treatment options available. Due to the rarity of the condition, practices differ across the world and the results are varied. These include beta-blockers, benzodiazepines and anti-epileptics. These treatments can have significant side-effects when used long term. However, botulinum toxin injections have been successfully used in a handful of cases. We report a successful botulinum treatment of hereditary geniospasm in a mother and son, with the injection protocols.

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Targeting Methods of Botulinum Toxin Injections for Cervical Dystonia

Case Medical Research ◽

10.31525/ct1-nct03946046 ◽

2019 ◽

Author(s):

Keyword(s):

Botulinum Toxin ◽

Cervical Dystonia ◽

Botulinum Toxin Injections

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Long-term efficacy and safety of botulinum toxin treatment for cervical dystonia: a critical reappraisal

Expert Opinion on Drug Safety ◽

10.1080/14740338.2021.1915282 ◽

2021 ◽

Author(s):

Luca Marsili ◽

Matteo Bologna ◽

Joseph Jankovic ◽

Carlo Colosimo

Keyword(s):

Botulinum Toxin ◽

Cervical Dystonia ◽

Efficacy And Safety ◽

Term Efficacy ◽

Botulinum Toxin Treatment

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Satisfaction with botulinum toxin treatment: a cross-sectional survey of patients with cervical dystonia

Journal of Medical Economics ◽

10.3111/13696998.2011.653726 ◽

2012 ◽

Vol 15 (3) ◽

pp. 419-423 ◽

Cited By ~ 46

Author(s):

Kapil D. Sethi ◽

Ramon Rodriguez ◽

Babajide Olayinka

Keyword(s):

Botulinum Toxin ◽

Cervical Dystonia ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Botulinum Toxin Treatment

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The clinical utility of botulinum toxin injections targeted at the motor endplate zone in cervical dystonia

European Journal of Neurology ◽

10.1111/ene.12517 ◽

2014 ◽

Vol 21 (12) ◽

pp. 1486-e98 ◽

Cited By ~ 10

Author(s):

C. C. S. Delnooz ◽

L. C. Veugen ◽

J. W. Pasman ◽

B. G. Lapatki ◽

J. P. van Dijk ◽

...

Keyword(s):

Botulinum Toxin ◽

Cervical Dystonia ◽

Clinical Utility ◽

Motor Endplate ◽

Botulinum Toxin Injections

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Adverse events with botulinum toxin treatment in cervical dystonia: How much should we blame placebo?

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2018.06.017 ◽

2018 ◽

Vol 56 ◽

pp. 16-19 ◽

Cited By ~ 6

Author(s):

Gonçalo S. Duarte ◽

Filipe B. Rodrigues ◽

Joaquim J. Ferreira ◽

João Costa

Keyword(s):

Botulinum Toxin ◽

Adverse Events ◽

Cervical Dystonia ◽

Botulinum Toxin Treatment

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Patient Selection Criteria for Deep Brain Stimulation for Dystonia

Deep Brain Stimulation ◽

10.1093/med/9780190647209.003.0035 ◽

2020 ◽

pp. 175-184

Author(s):

Laura S. Surillo Dahdah ◽

Rasheda El-Nazer ◽

Richard B. Dewey ◽

Padraig O’Suilleabhain ◽

Shilpa Chitnis

Keyword(s):

Botulinum Toxin ◽

Patient Selection ◽

Muscle Activation ◽

Age At Onset ◽

Voluntary Action ◽

Body Distribution ◽

Segmental Dystonia ◽

Generalized Dystonia ◽

Patient Selection Criteria ◽

Botulinum Toxin Injections

Dystonia is defined as a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Dystonic movements are typically patterned and twisting and may be tremulous. Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. A recent revision now classifies dystonia into two axes: (1) clinical characteristics (age at onset, temporal pattern, body distribution, whether focal, segmental, or generalized; and associated features) and (2) etiology, whether idiopathic/genetic or secondary to other neurological/medical diseases. Pharmacological treatments for dystonia remain generally unsatisfactory and consist of various combinations of levodopa, anticholinergics, muscle-relaxing drugs as well as botulinum toxin injections in focal and segmental dystonia. Overall in outcomes are poor because of limited efficacy and the potential for significant side effects such as sedation and cognitive impairment. A humanitarian-device exemption from the Food and Drug Administration was issued for the treatment of medically refractory symptoms of generalized dystonia with the use of DBS. Bilateral GPi DBS surgery is effective for both generalized and focal dystonia including cervical dystonia and tardive dystonia. DBS may be the best available treatment for disabling symptoms of generalized, cervical, tardive, and other dystonia that have failed to respond to oral drugs and botulinum toxin injections (when applicable) as long as contractures have not developed, because in this situation, DBS will be ineffective. Rigorous patient selection and careful management of comorbidities are essential for favorable outcomes.

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