Botulinum toxin type A therapy for blepharospasm

Costa, João; Espírito-Santo, C; Borges, Ana A; Ferreira, Joaquim J.; Coelho, Miguel; Moore, Peter; Sampaio, Cristina

doi:10.1002/14651858.cd004900.pub2

Cited by 58 publications

(20 citation statements)

References 36 publications

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“…One Cochrane review analysed BoNT-A efficacy in blepharospasm, but the authors concluded that there were no high quality randomized controlled studies to support the use of BoNT-A for blepharospasm [74]. A narrative review of 55 open control studies conducted on 4340 patients in 28 countries reported a success rate of approximately 90% [75].…”

Section: Treatment Botulinum Toxinsmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review on the diagnosis and treatment of primary (idiopathic) dystonia and dystonia plus syndromes: report of an EFNS/MDS‐ES Task Force

Albanese

Barnes²,

Bhatia

et al. 2006

Euro J of Neurology

257

199

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To review the literature on primary dystonia and dystonia plus and to provide evidencebased recommendations. Primary dystonia and dystonia plus are chronic and often disabling conditions with a widespread spectrum mainly in young people. Computerized MEDLINE and EMBASE literature reviews (1966( -1967( February 2005 were conducted. The Cochrane Library was searched for relevant citations. Diagnosis and classification of dystonia are highly relevant for providing appropriate management and prognostic information, and genetic counselling. Expert observation is suggested. DYT-1 gene testing in conjunction with genetic counselling is recommended for patients with primary dystonia with onset before age 30 years and in those with an affected relative with early onset. Positive genetic testing for dystonia (e.g. DYT-1) is not sufficient to make diagnosis of dystonia. Individuals with myoclonus should be tested for the epsilon-sarcoglycan gene (DYT-11). A levodopa trial is warranted in every patient with early onset dystonia without an alternative diagnosis. Brain imaging is not routinely required when there is a confident diagnosis of primary dystonia in adult patients, whereas it is necessary in the paediatric population. Botulinum toxin (BoNT) type A (or type B if there is resistance to type A) can be regarded as first line treatment for primary cranial (excluding oromandibular) or cervical dystonia and can be effective in writing dystonia. Actual evidence is lacking on direct comparison of the clinical efficacy and safety of BoNT-A vs. BoNT-B. Pallidal deep brain stimulation (DBS) is considered a good option, particularly for generalized or cervical dystonia, after medication or BoNT have failed to provide adequate improvement. Selective peripheral denervation is a safe procedure that is indicated exclusively in cervical dystonia. Intrathecal baclofen can be indicated in patients where secondary dystonia is combined with spasticity. The absolute and comparative efficacy and tolerability of drugs in dystonia, including anticholinergic and antidopaminergic drugs, is poorly documented and no evidence-based recommendations can be made to guide prescribing. ObjectivesThe objective of the task force was to review the literature on diagnosis and treatment of primary dystonia and dystonia plus to provide evidence-based recommendations for diagnosis and treatment.

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Section: Treatment Botulinum Toxinsmentioning

confidence: 99%

“…(1) BoNT-A (or type B if there is resistance to type A) can be regarded as first line treatment for primary cranial (excluding oromandibular) or cervical dystonia [74,75] (level A).…”

Section: Recommendations and Good Practice Pointsmentioning

confidence: 99%

A systematic review on the diagnosis and treatment of primary (idiopathic) dystonia and dystonia plus syndromes: report of an EFNS/MDS‐ES Task Force

Albanese

Barnes²,

Bhatia

et al. 2006

Euro J of Neurology

257

199

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“…69–71 A recent Cochrane systematic review has concluded that doing more RCTs to prove the effectiveness of Botox over the placebo (saline) would be unethical due to the high efficacy and obvious benefits of Botox in treating blepharospasm. 72 …”

Section: Resultsmentioning

confidence: 99%

An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions

et al. 2013

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Botulinum toxin (Botox) is an exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles or glands innervated. Botox is best known for its beneficial role in facial aesthetics but recent literature has highlighted its usage in multiple non-cosmetic medical and surgical conditions. This article reviews the current evidence pertaining to Botox use in the head and neck. A literature review was conducted using The Cochrane Controlled Trials Register, Medline and EMBASE databases limited to English Language articles published from 1980 to 2012. The findings suggest that there is level 1 evidence supporting the efficacy of Botox in the treatment of spasmodic dysphonia, essential voice tremor, headache, cervical dystonia, masticatory myalgia, sialorrhoea, temporomandibular joint disorders, bruxism, blepharospasm, hemifacial spasm and rhinitis. For chronic neck pain there is level 1 evidence to show that Botox is ineffective. Level 2 evidence exists for vocal tics, trigeminal neuralgia, dysphagia and post-laryngectomy oesophageal speech. For stuttering, ‘first bite syndrome’, facial nerve paresis, Frey's syndrome, oromandibular dystonia and palatal/stapedial myoclonus the evidence is level 4. Thus, the literature highlights a therapeutic role for Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence). With ongoing research, the spectrum of clinical applications and number of people receiving Botox will no doubt increase. Botox appears to justify its title as ‘the poison that heals’.

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“…Costa et al 5 carried out an extensive search to establish high-quality, randomized, controlled efficacy data to support the use of BTX type A for blepharospasm. Unfortunately they could not find any, but they did find studies suggesting that BTX type A is highly effective and safe for treating blepharospasm.…”

Section: Discussionmentioning

confidence: 99%

Difference in response to botulinum toxin type A treatment between patients with benign essential blepharospasm and hemifacial spasm

Cannon

MacKenzie

Cook

et al. 2010

Clinical Exper Ophthalmology

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Botulinum toxin type A therapy for blepharospasm

Cited by 58 publications

References 36 publications

A systematic review on the diagnosis and treatment of primary (idiopathic) dystonia and dystonia plus syndromes: report of an EFNS/MDS‐ES Task Force

A systematic review on the diagnosis and treatment of primary (idiopathic) dystonia and dystonia plus syndromes: report of an EFNS/MDS‐ES Task Force

An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions

Difference in response to botulinum toxin type A treatment between patients with benign essential blepharospasm and hemifacial spasm

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