Botulinum toxin type A therapy for cervical dystonia

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

doi:10.1002/14651858.cd003633.pub2

Cited by 80 publications

(77 citation statements)

References 21 publications

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“…The AEs reported with BoNT type-A were noted in weeks 1-3, most frequently with bilateral sternocleidomastoid injections for anterocollis. Dysphagia, similar to previous CD studies (Comella, Tanner, DeFoor-Hill, & Smith, 1992;Costa et al, 2005a) injections were performed in a consecutive manner for limb dystonias as follows: four upper limb and six lower limb injections per toxin arm (n = 20). The ages of patients and duration of illness ranged from 28 to 50 years and 2 to 12 years, respectively.…”

Section: Bont Type-a Versus Mab In Cervical Dystonia Of Xdpmentioning

confidence: 93%

“…The pharmacological approach in dystonia remains limited to symptomatic treatment with anticholinergic drugs, muscle relaxants, and dopamine-depleting agents (Horn & Comella, 2004). In cervical dystonia (CD), botulinum toxin (BoNT) therapy has been favored over an anticholinergic drug (trihexyphenidyl) (Brans et al, 1996) and was similar in effect size to that obtained in a systematic review comparing BoNT type-A and placebo, with better tolerability (Costa et al, 2005a).…”

Section: Introductionmentioning

confidence: 89%

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The Broadening Application of Chemodenervation in X-Linked Dystonia-Parkinsonism (Part I): Muscle Afferent Block Versus Botulinum Toxin-A in Cervical and Limb Dystonias

Rosales

Santos²,

Ng³

et al. 2011

International Journal of Neuroscience

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Botulinum toxin (BoNT) is an established mainstay treatment for dystonia. However, its use, especially in developing countries, is significantly limited by its cost. Chemodenervation with muscle afferent block (MAB) using lidocaine-ethanol may provide a more cost-effective alternative to traditional BoNT injections. A study comparing MAB with BoNT type-A in cases of X-linked dystonia-Parkinsonism (XDP) having cervical dystonia indicated a modest and short-lived efficacy with MAB, while a more robust efficacy in dystonia and pain parameters, lasting up to 11 weeks, was observed in the two BoNT type-A preparations (Dysport® and Botox®). In another study comparing BoNT type-A formulations for limb dystonia of XDP, a prior MAB was used to select target muscles for toxin injection. During toxin injections in the limb muscles, Dysport® and Botox® did not show significant differences with regard to global severity and disability scales, duration of effect, and adverse event (AE) profile. Dysphagia was the most common AE following BoNT type-A injections in cervical dystonia, while weakness was the most frequent AE noted with injections for limb dystonia. MAB injections carried a high incidence of dizziness and pain during injections. However, because MAB is a more cost-effective alternative that can be given repeatedly, it has been used in the XDP population while awaiting funds for BoNT type-A and/or for selecting muscles for injection as a test drug.

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Section: Bont Type-a Versus Mab In Cervical Dystonia Of Xdpmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 89%

The Broadening Application of Chemodenervation in X-Linked Dystonia-Parkinsonism (Part I): Muscle Afferent Block Versus Botulinum Toxin-A in Cervical and Limb Dystonias

Rosales

Santos²,

Ng³

et al. 2011

International Journal of Neuroscience

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“…In a meta-analysis (8 trials with 361 patients using Ona"oNT"; 5 trials with 319 patients using "bo"oNT"), it was shown that there was a statistically and clinically signiicant improvement on objective rating scales and subjective rating scales as well as for pain relief in subjective scales [7]. The same was also seen in a realworld design study (1046 patients) showing robust improvement in clinical ratings as measured via both physician-and subject-reported outcomes and excellent tolerability following Ona"oNT" treatment of CD [30].…”

Section: Treatment Of Cervical Dystoniamentioning

confidence: 99%

“…" single injection cycle of "oNT is efective and safe for treating CD, and further injection cycles continue to work for most patients [7].…”

Section: Treatment Of Cervical Dystoniamentioning

confidence: 99%

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How Effective and Safe is Botulinum Toxin Therapy in Cervical Dystonia: The Current Stand

Jamora¹,

Piano²

2016

Botulinum Toxin Therapy Manual for Dystonia and Spasticity

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Cervical dystonia (CD) is the most common focal dystonia that is characterized by involuntary contraction of cervical muscles causing abnormal head movements and postures. The treatment for CD was previously limited to oral medications, however, with consequent systemic side efects. In recent years, botulinum toxin ("oNT) has demonstrated eicacy in several studies and thus has received level " recommendation from both the "merican "cademy of Neurology and the European Federation of Neurological Sciences in the treatment of dystonia. In many countries, it is the irst-line treatment for CD. There are four types of toxin approved for the use in CD, three type " [Onabotulinumtoxin" (Ona"oNT"), "bobotulinumtoxin" ("bo"oNT"), and Incobotulinumtoxin " (Inco"oNT")] and one type " [Rimabotulinumtoxin" (Rima-"oNT")]. Proper selection of afected muscles and dose of toxin are important parameters in successfully providing symptomatic treatment. Good response rate is deined as improvement of more than 25 % from baseline using the Toronto Western Torticollis Rating Scale. The most common side efect of chemodenervation with "oNT for CD is dysphagia.

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