Electrophysiological studies in patients with blepharospasm before and after botulinum toxin A therapy

Behari, Madhuri; Raju, Garuda Butchi

doi:10.1016/0022-510x(95)00259-5

Cited by 17 publications

(13 citation statements)

References 14 publications

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“…Such remote hypoexcitability of BT injection may contribute to reducing distant synergistic contractions (overflow), as has been reported in some cases of nonspastic dystonic syndromes [64,65]. Other central reflex alterations have also been reported after blepharospasm injections [66]; although other blepharospasm or cervical studies have been negative in that respect [67,68].…”

Section: Central Effects In Humansmentioning

confidence: 91%

The role of botulinum toxin injections in the management of muscle overactivity of the lower limb

Singer

Dunne

2007

Disability and Rehabilitation

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Muscle overactivity is common in patients with adult onset central nervous system damage. It can produce significant disablement in conjunction with other impairments such as adaptive soft tissue shortening and loss of muscle strength. Muscle overactivity is not evenly distributed throughout the body; across joints there is frequently imbalance between agonist and antagonist, producing abnormal joint postures and movement patterns. Due to the asymmetric nature of the abnormal activity across joints, in general we recommend local treatment targeting the more overactive of the two agonists, rather than systemic treatment. Considerable experience with the use of botulinum toxin, both serotypes A and B, in the treatment of muscle overactivity has been accumulated in the last two decades through pragmatic clinical practice and open label studies, supported by an increasing number of randomized controlled trials. In most cases, it is important to use botulinum toxin injection for treatment of muscle overactivity in the setting of wider rehabilitation goals and interventions. Focal and partial blocks with botulinum toxin should be used as a component of a general neurorehabilitation programme rather than as an alternative to other treatments. We review the evidence supporting the use of botulinum toxin to treat muscle overactivity in the lower limb, present practical guidelines on when and how to use botulinum toxin and provide direction for future research.

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Section: Central Effects In Humansmentioning

confidence: 91%

The role of botulinum toxin injections in the management of muscle overactivity of the lower limb

Singer

Dunne

2007

Disability and Rehabilitation

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“…Similarly, Valls-Solé et al (1994) found no correlation between the clinical improvement induced by BoNT-A in patients with cervical dystonia and changes in brainstem interneuronal excitability. Nor did BoNT-A injections induce changes in brainstem auditory evoked potentials (Behar and Raju, 1996;Ce, 2000).…”

Section: Effects Of Bont-a On Brainstem Mechanismsmentioning

confidence: 99%

Neurophysiological effects of botulinum toxin type a

Abbruzzese

Berardelli

2006

neurotox res

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Botulinum toxin type A (BoNT-A) acts peripherally by inhibiting acetylcholine release from the presynaptic neuromuscular terminals, thus weakening muscle contraction, and its clinical benefit depends primarily on the toxin's peripheral action. In addition to acting directly at the neuromuscular junction, the toxin alters sensory inputs to the central nervous system, thus indirectly inducing secondary central changes. Some of the long-term clinical benefits of BoNT-A treatment may also reflect plastic changes in motor output after the reorganization of synaptic density.

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“…Blepharospasm is often exacerbated by stress and impacts the amplitude of the blink reflex, possibly as a function of synaptic exhaustion resulting from excessive spasms of the orbicularis oculi muscle (e.g. see Behari & Raju, 1996). As a consequence, we cannot definitively conclude that the acoustic startle protocol was effective in reducing the startle reflex on the basis of EMG recordings.…”

Section: Discussionmentioning

confidence: 90%

Is Acoustic Startle a Viable Exposure Protocol for Posttraumatic Stress Disorder? A Clinical Case Study

Asmundson

Carleton

2010

Cognitive Behaviour Therapy

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Exaggerated startle is a common symptom (based on Diagnostic and Statistical Manual of Mental Disorders [fourth edition] Criterion D) for many patients with posttraumatic stress disorder (PTSD). Findings from previous studies suggest that exaggerated startle may be due to trauma exposure or pretrauma vulnerability factors for PTSD development. The present clinical case study reports on a patient with PTSD characterized by a very prominent startle response and preference against standard trauma-related exposure strategies. On the basis of recent findings that interoceptive exposure exercises (e.g. shaking head side to side, hyperventilation) elicit trauma-related memories (Wald & Taylor, 2008), the authors sought to determine whether repeated application of an acoustic startle stimulus would serve to diminish the prominent startle response and facilitate exposure and overall symptom reduction by eliciting trauma-related memories. The protocol was successful in eliciting vivid and distressing trauma-related memories. Over the course of seven exposure trials, the patient demonstrated a decrease in distress elicited during the protocol, improved mood, and reduced general anxiety and trauma-related distress. He also reported significantly decreased startle response to loud noises encountered during activities of daily living. Although preliminary, these finding suggest that the acoustic startle protocol may be a viable (interoceptive) exposure strategy for individuals with PTSD, particularly those with exaggerated startle responses and those who are not amenable to standard trauma-related exposure strategies.

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Electrophysiological studies in patients with blepharospasm before and after botulinum toxin A therapy

Cited by 17 publications

References 14 publications

The role of botulinum toxin injections in the management of muscle overactivity of the lower limb

The role of botulinum toxin injections in the management of muscle overactivity of the lower limb

Neurophysiological effects of botulinum toxin type a

Is Acoustic Startle a Viable Exposure Protocol for Posttraumatic Stress Disorder? A Clinical Case Study

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