Botulinum toxin A improves involuntary limb movements in Rasmussen syndrome

Lozsádi, Dora A.; Hart, Ian; Moore, Austen P

doi:10.1212/01.wnl.0000118283.51400.7a

Cited by 17 publications

(14 citation statements)

References 7 publications

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“…66 Cases are reported of botulinum toxin successfully injected into the zygomaticus for facial myoclonus and into upper limb muscles for localised epilepsia partialis continua, reducing painful spasms and improving functional use of the limb. 67,68 Case series of short-term intense immuno-interventions, such as steroid pulses, apheresis treatment, 44 and a case report and an open-label trial of rituximab infusions 13,69 have shown a temporary beneficial effect on seizure frequency. In 2011, case reports were published of seizure improvement with vagus nerve stimulation therapy and transcranial magnetic stimulation.…”

Section: Treatmentmentioning

confidence: 99%

Rasmussen's encephalitis: clinical features, pathobiology, and treatment advances

Varadkar¹,

Bien²,

Kruse³

et al. 2014

The Lancet Neurology

392

412

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Rasmussen’s encephalitis is a rare chronic neurological disorder, characterised by unilateral inflammation of the cerebral cortex, drug-resistant epilepsy, and progressive neurological and cognitive deterioration. Neuropathological and immunological studies support the notion that Rasmussen’s encephalitis is probably driven by a T-cell response to one or more antigenic epitopes, with potential additional contribution by autoantibodies. Careful analysis of the association between histopathology and clinical presentation suggests that initial damage to the brain is mediated by T cells and microglia, suggesting a window for treatment if Rasmussen’s encephalitis can be diagnosed early. Advances in neuroimaging suggest that progression of the inflammatory process seen with MRI might be a good biomarker in Rasmussen’s encephalitis. For many patients, families, and doctors, choosing the right time to move from medical management to surgery is a real therapeutic dilemma. Cerebral hemispherectomy remains the only cure for seizures, but there are inevitable functional compromises. Decisions of whether or when surgery should be undertaken are challenging in the absence of a dense neurological deficit, and vary by institutional experience. Further, the optimum time for surgery, to give the best language and cognitive outcome, is not yet well understood. Immunomodulatory treatments seem to slow rather than halt disease progression in Rasmussen’s encephalitis, without changing the eventual outcome.

show abstract

Section: Treatmentmentioning

confidence: 99%

Rasmussen's encephalitis: clinical features, pathobiology, and treatment advances

Varadkar¹,

Bien²,

Kruse³

et al. 2014

The Lancet Neurology

392

412

View full text Add to dashboard Cite

show abstract

“…Transient improvement of dystonia has been reported after intravenous immunoglobulins7 or botulinum toxin 8. These were ineffective in our patient and neuromodulation was considered after extensive discussion.…”

Section: Discussionmentioning

confidence: 72%

“…In Rasmussen’s disease, movement disorders have been described in association to epilepsy, including dystonia7 and very recently, hemiparkinsonism 8. These signs may be overlooked or under-reported in some patients, given the severity of epilepsy and gross hemispheric dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Unilateral pallidal stimulation for disabling dystonia due to Rasmussen’s disease

Carreño

Martı́

Aldecoa

et al. 2018

J Neurol Neurosurg Psychiatry

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“…66 Cases are reported of botulinum toxin successfully injected into the zygomaticus for facial myoclonus and into upper limb muscles for localised epilepsia partialis continua,reducing painful spasms and improving functional use of the limb. 67,68 Case series of short-term intense immuno-interventions, such as steroid pulses, apheresis treatment, 44 and a case report and an open-label trial of rituximab infusions 13,69 have shown a temporary benefi cial eff ect on seizure frequency. In 2011, case reports were published of seizure improvement with vagus nerve stimulation therapy and transcranial magnetic stimulation.…”

Section: Seizuresmentioning

confidence: 99%

The effect of cytokinins on in vitro shoot length and multiplication of Hymenocallis littoralis

Chai¹,

Balakrishnan²,

Jeev³

et al. 2010

J. Med. Plants Res.

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Rasmussen's encephalitis is a rare chronic neurological disorder, characterised by unilateral infl ammation of the cerebral cortex, drug-resistant epilepsy, and progressive neurological and cognitive deterioration. Neuropathological and immunological studies support the notion that Rasmussen's encephalitis is probably driven by a T-cell response to one or more antigenic epitopes, with potential additional contribution by autoantibodies. Careful analysis of the association between histopathology and clinical presentation suggests that initial damage to the brain is mediated by T cells and microglia, suggesting a window for treatment if Rasmussen's encephalitis can be diagnosed early. Advances in neuroimaging suggest that progression of the infl ammatory process seen with MRI might be a good biomarker in Rasmussen's encephalitis. For many patients, families, and doctors, choosing the right time to move from medical management to surgery is a real therapeutic dilemma. Cerebral hemispherectomy remains the only cure for seizures, but there are inevitable functional compromises. Decisions of whether or when surgery should be undertaken are challenging in the absence of a dense neurological defi cit, and vary by institutional experience. Further, the optimum time for surgery, to give the best language and cognitive outcome, is not yet well understood. Immunomodulatory treatments seem to slow rather than halt disease progression in Rasmussen's encephalitis, without changing the eventual outcome.

show abstract

Botulinum toxin A improves involuntary limb movements in Rasmussen syndrome

Cited by 17 publications

References 7 publications

Rasmussen's encephalitis: clinical features, pathobiology, and treatment advances

Rasmussen's encephalitis: clinical features, pathobiology, and treatment advances

Unilateral pallidal stimulation for disabling dystonia due to Rasmussen’s disease

The effect of cytokinins on in vitro shoot length and multiplication of Hymenocallis littoralis

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