A double-blind, controlled study of botulinum toxin A in chronic myofascial pain

Richards, Bruce A.

doi:10.1212/01.wnl.0000259663.93466.33

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…With that success, the first double-blind trial testing botulinum toxin A for blepharospasm was conducted. [ 27 ] Eight subjects were injected; 5 were injected unilaterally, with the other eye receiving saline as a control. Despite the double-blind protocol, the 5 patients and the investigators were able to detect the eye that received botulinum toxin owing to the less forceful contractions and shorter times of eyelid closure.…”

Section: Early Use Of Botulinum Toxin a As A Treatment For Strabismus...mentioning

confidence: 99%

“…[ 32 ] Due to the dramatic results from the open-label trials, few randomized, controlled trials have been undertaken for blepharospasm. [ 12 , 27 , 32 ] In one of the trials submitted to the FDA for approval, 27 patients with persistent moderate to severe blepharospasm, of which 26 had not responded to previous drug treatments, were treated with 2U of Oculinum in 6 sites per side (total of 12U per eye). [ 14 ] Of these, 25 patients reported an improvement in eyelid force and eyelid spasm within 48 hours, with a mean duration of effect of 8.1 weeks (range: 2–17 weeks).…”

Section: Efficacy and Safety Highlightsmentioning

confidence: 99%

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Treatment of strabismus and blepharospasm with Botox (onabotulinumtoxinA): Development, insights, and impact

2023

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Strabismus, deviation of the ocular alignment, can adversely affect quality of life and activities of daily living. Surgery was the prior standard of care for strabismus, but up to 40% of patients required additional surgeries. This need for more effective and less invasive treatment, along with the convergence of other events such as the development of electromyography, purification of botulinum toxin A, and the finding that injection of botulinum toxin type A could paralyze the hind limbs of chicks, led Dr. Alan Scott to investigate injection of his formulation for strabismus. The positive results of initial trials in monkeys segued to human trials with observations of alignment improvements and few adverse events. The success of botulinum toxin type A in the treatment of strabismus led to interest in its use to treat other skeletal muscles, particularly in blepharospasm, a type of focal dystonia involving eyelid spasms and involuntary eye closure that lacked an effective pharmacological treatment. Patient groups helped to increase awareness of this novel treatment, and results from clinical trials confirmed its effectiveness. Dr. Scott’s formulation, then known as Oculinum, received its first Food and Drug Administration approvals in 1989 for strabismus and blepharospasm. Allergan acquired Oculinum in 1991, renaming it Botox. These initial uses led to its application in a myriad of other indications as outlined in other articles of this supplement.

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Section: Early Use Of Botulinum Toxin a As A Treatment For Strabismus...mentioning

confidence: 99%

Section: Efficacy and Safety Highlightsmentioning

confidence: 99%

Treatment of strabismus and blepharospasm with Botox (onabotulinumtoxinA): Development, insights, and impact

2023

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“…Botulinum toxin treatment is based on this principle (Ernberg et al, 2011). However, previous studies have reported that injection of botulinum toxin A into the MTrP area had no effect on mechanical pain thresholds or pain intensity (Ernberg et al, 2011;Richards, 2007). Furthermore, reports indicate that intramuscular injection of a small amount of acetylcholinesterase inhibitor resulted in muscle fibre breakage and contractile nodules at the injection site (Mense et al, 2003) that were different from the abnormally contractile sarcomeres in MTrPs biopsied from MPS patients.…”

Section: Rhoa and Rac1 But Not Cdc42 Are Activated In The Contracmentioning

confidence: 99%