Botulinum toxin in writer's cramp: objective response evaluation in 31 patients.

Wissel, Jörg; Kabus, Christian; Wenzel, René R.; Klepsch, S; Schwarz, Ute I.; Nebe, Angelika; Schelosky, Ludwig; Scholz, Udo; Poewe, Werner

doi:10.1136/jnnp.61.2.172

Cited by 144 publications

(95 citation statements)

References 11 publications

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“…We also confirmed the diagnosis with four-channel surface electromyography recorded from the involved upper extremity. For objective clinical assessments, we used the methods described by Wissel et al [7]. Informed consent to the surgical treatment was obtained from the patient and the family.…”

Section: Methodsmentioning

confidence: 99%

Stereotactic Ventrooralis Thalamotomy for Task-Specific Focal Hand Dystonia (Writer’s Cramp)

Taira

Hori²

2003

Stereotact Funct Neurosurg

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Background: Writer’s cramp is a type of focal dystonia due to dysfunction of the pallido-thalamo-cortical circuit. The symptom is refractory to most conservative treatment, though botulinum toxin injection is generally used for symptomatic relief. As a surgical treatment of dystonia, we performed stereotactic nucleus ventrooralis (Vo) thalamotomy for dystonic cramp of the hand. Methods: Twelve patients (5 men, 3 women; age 26–40 years, mean 32.1 years) with medically intractable task-specific focal dystonia of the hand underwent Vo thalamotomy. The stereotactic target was chosen at the junction of the anterior and posterior Vo nuclei. Results: The mean duration of the symptom ranged from 3 to 6 years (mean 4.5 years.) All patients had complained of difficulty in writing. Seven patients were professionals, such as a comic artist, guitarist and barber, and, because of the dystonic symptoms occurring during their work, they had stopped pursuing their profession. All patients showed immediate postoperative disappearance of dystonic symptoms, and the effect was sustained during the follow-up period (3–33 months, mean 13.1 months), except in one case. Two patients showed partial recurrence of the symptom and underwent second thalamotomy 5 months after the initial surgery with satisfactory results. The score on the writer’s cramp rating scale decreased significantly (p < 0.001) after Vo thalamotomy. There were no permanent operative complications. There was no mortality or permanent morbidity. Conclusion: Although a longer follow-up is needed, stereotactic Vo thalamotomy is a useful and safe therapeutic option for writer’s cramp.

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Section: Methodsmentioning

confidence: 99%

Stereotactic Ventrooralis Thalamotomy for Task-Specific Focal Hand Dystonia (Writer’s Cramp)

Taira

Hori²

2003

Stereotact Funct Neurosurg

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“…Dystonic symptoms of adjacent or remote body parts were absent. Mean disease duration was 6.7 ± 6.6 years and the mean total writer's cramp rating scale (WCRS) (Wissel et al 1996) amounted to 9.7 ± 3.9. None of the participants had a history of other neurological or psychiatric disease, and neurological examination was normal except for focal hand dystonia in the patient group.…”

Section: Subjectsmentioning

confidence: 99%

Deficient Homeostatic Regulation of Practice-Dependent Plasticity in Writer’s Cramp

et al. 2010

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Homeostatic metaplasticity is important to maintain overall synaptic weight in neuronal networks. Previous work suggested that homeostatic metaplasticity in motor cortex is impaired in writer's cramp, the most common form of task-specific focal dystonia, when explored by the interactions between 2 successive plasticity inducing transcranial brain stimulation protocols (Quartarone Rizzo V, Bagnato S, Morgante F, Sant'angelo A, Romano M, Crupi D, Girlanda P, Rothwell JC, Siebner HR. 2005. Homeostatic-like plasticity of the primary motor hand area is impaired in focal hand dystonia. Brain. 128:1943Brain. 128: --1950. To which extent deficient homeostatic metaplasticity applies also to the behavioral level of practicedependent plasticity is unknown. Here, we examined the interactions of 3 paired associative transcranial magnetic stimulation protocols (motor cortical excitability-enhancing paired associative stimulation (PAS) 25ms , excitability-depressing PAS 10ms , and control PAS 100ms ) with subsequent practice-dependent plasticity. Ten patients with writer's cramp and 10 healthy controls practiced rapid thumb abductions for 30 min. Practice-dependent plasticity was quantified by the increase in peak acceleration of the trained movement. The healthy controls but not the writer's cramp patients showed homeostatic suppression of practice-dependent plasticity after PAS 25ms when compared with practice-dependent plasticity after PAS 10ms and PAS 100ms . The lack of the PAS 25ms -induced suppression of practice-dependent plasticity in writer's cramp correlated with clinical severity of the focal hand dystonia. Findings support the notion that deficient homeostatic metaplasticity of practicedependent plasticity plays a significant role in the pathophysiology of writer's cramp.

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“…Достаточно частое нежелательное явление -наличие слабости в руке после инъекции [18]. Комбинации мышц, рекомендуемые для инъекции, ва-рьируют в разных исследованиях, не определены опти-мальные дозы препарата БТА.…”

Section: Discussionunclassified

Experience of botulinum toxin in treatment of writer’s cramp

Charnukha

Charnenko

2015

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Botulinum toxin in writer's cramp: objective response evaluation in 31 patients.

Cited by 144 publications

References 11 publications

Stereotactic Ventrooralis Thalamotomy for Task-Specific Focal Hand Dystonia (Writer’s Cramp)

Stereotactic Ventrooralis Thalamotomy for Task-Specific Focal Hand Dystonia (Writer’s Cramp)

Deficient Homeostatic Regulation of Practice-Dependent Plasticity in Writer’s Cramp

Experience of botulinum toxin in treatment of writer’s cramp

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