Five‐year experience in the treatment of focal movement disorders with low‐dose dysport^TM botulinum toxin

Abstract

We report the results of botulinum toxin type A (Dysport, Porton Products, UK) treatment over 5 years in 107 patients with blepharospasm, Meige's syndrome, oromandibular dystonia, hemifacial spasm, cervical dystonia, and writer's cramp. Electromyography was used to localize dystonic muscles and guide Dysport injections in Meige's syndrome, oromandibular dystonia, cervical dystonia, and writer's cramp. All but 2 Meige's syndrome and 2 writer's cramp patients responded to treatment. Improvement was dramatic in blepharospasm (79%) and hemifacial spasm (90%); pronounced in cervical dystonia (74%); and moderate in Meige's syndrome (53%), oromandibular dystonia (57%), and writer's cramp (34%). Although Dysport doses were 50-75% lower than usually reported, response and improvement rates as well as relapse intervals were similar to those of others. To treat cervical dystonia relapses, only 50% of the initial dose was required for continued optimal relief of symptoms. Low-dose Dysport was associated with a very low incidence of dysphagia in cervical dystonia.

Avaliação da fenda palpebral após aplicação de toxina botulínica tipo A em pacientes com distonias faciais

“…Os efeitos colaterais decorrentes da injeção da toxina botulínica são passageiros. Ptose palpebral é a complicação mais comum (18)(19)(20)(21) . Neste estudo, não houve diminuição da fenda palpebral após aplicação de toxina botulínica.…”

Current and future medical treatment in primary dystonia

“…BoNT treatment trials in oromandibular dystonia (OMD) have been small and/or open label [Blitzer et al 1989;Hermanowicz and Truong, 1991;Van Den Bergh et al 1995;Poungvarin et al 1997;Tan and Jankovic, 1999;Laskawi and Rohrbach, 2001]. The largest prospective openlabel study, concerning 162 patients, reported moderate to excellent improvement in almost 70% of OMD patients.…”

Blefaroespasmo essencial benigno

“…Resultados favoráveis do tratamento das distonias focais com ambas as preparações tem sido publicados (10)(11)(12)(13) .…”

“…Baseado em unidades de peso, Dysport ® é 16 vezes mais potente do que o Botox ® (40 unidades internacionais (UI) e 2,5 UI por nanograma do complexo toxina-hemaglutinina, respectivamente). Baseado em unidades de atividade biológica, 1 UI de Botox ® é equivalente a 4 UI de Dysport ® (11) .…”

“…Ptose palpebral é a complicação mais comum. Outras alterações são a ceratite, lacrimejamento, olho seco, diplopia, edema palpebral, piscar incompleto, lagoftalmo, quemose, entrópio ou ectrópio, dor local, embaçamento visual e parestesia facial (10)(11)(12)(13)(14)(15)(16) .…”