Localized injections of botulinum toxin for the treatment of focal dystonia and hemifacial spasm
Identifieur interne : 006609 ( Main/Exploration ); précédent : 006608; suivant : 006610Localized injections of botulinum toxin for the treatment of focal dystonia and hemifacial spasm
Auteurs : Brin [États-Unis] ; Stanley Fahn [États-Unis] ; Carol Moskowitz [États-Unis] ; Andrzej Friedman [États-Unis] ; Heidi M. Shale [États-Unis] ; Paul E. Greene [États-Unis] ; Andrew Blitzer [États-Unis] ; Theodore List [États-Unis] ; Dale Lange [États-Unis] ; Robert E. Lovelace [États-Unis] ; Don Mcmahon [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 1987.
English descriptors
- KwdEn :
- Adult, Aged, Blepharospasm, Blepharospasm (drug therapy), Botulinum Toxins (administration & dosage), Botulinum toxin, Dose-Response Relationship, Drug, Dystonia (drug therapy), Electromyography, Facial Muscles (drug effects), Female, Focal dystonias, Follow-Up Studies, Hemifacial spasm, Humans, Injections, Intramuscular, Injections, Subcutaneous, Male, Middle Aged, Spasm (drug therapy), Spastic dysphonia, Torticollis, Torticollis (drug therapy).
- MESH :
- chemical , administration & dosage : Botulinum Toxins.
- drug effects : Facial Muscles.
- drug therapy : Blepharospasm, Dystonia, Spasm, Torticollis.
- Adult, Aged, Dose-Response Relationship, Drug, Electromyography, Female, Follow-Up Studies, Humans, Injections, Intramuscular, Injections, Subcutaneous, Male, Middle Aged.
Abstract
Medical treatment of dystonia usually results in an incomplete response and is frequently unsuccessful. Peripheral surgical therapy is available for some focal dystonias, but may only offer temporary relief and may have unacceptable complications. We have used local injections of botulinum toxin into the appropriate muscles for treatment of disabling focal or segmental dystonia in 93 patients with torticollis, blepharospasm, oromandibular dystonia (OMD), limb dystonia, lingual dystonia, and dystonia adductor dysphonia, in addition to four patients with hemifacial spasm. Significant relief of motor symptoms was seen in 69% of the patients with blepharospasm and 64% of patients with torticollis; 74% of the latter group with pain experience relief. Relief of symptoms was noted in most patients with OMD and limb dystonia, and all with lingual dystonia, dystonic adductor spastic dysphonia, and those with hemifacial spasm. Benefit averaged 2½‐3 months initially; however some patients experienced longer relief with subsequent injections. Adverse effects were transient, although 2 patients developed antibodies against the toxin, and we documented evidence for distant effects in others. This approach of chemically weakening contracting muscles in focal dystonia offers many advantages over pharmacotherapy and surgical therapy. Additional experience is needed to explore the proper doses, and potential for long term adverse effects.
Url:
DOI: 10.1002/mds.870020402
Affiliations:
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Lovelace</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Dystonia Clinical Research Center, and the Department of Neurology, Columbia University College of Physicians and Surgeons and Presbyterian Hospital, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Mcmahon, Don" sort="Mcmahon, Don" uniqKey="Mcmahon D" first="Don" last="Mcmahon">Don Mcmahon</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>General Clinical Research Center, Columbia University College of Physicians and Surgeons and Presbyterian Hospital, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="1987">1987</date><biblScope unit="vol">2</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="237">237</biblScope><biblScope unit="page" to="254">254</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">8D1C0A2ED110F456A67F4FE58CF350A32696D9F4</idno><idno type="DOI">10.1002/mds.870020402</idno><idno type="ArticleID">MDS870020402</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Blepharospasm</term><term>Blepharospasm (drug therapy)</term><term>Botulinum Toxins (administration & dosage)</term><term>Botulinum toxin</term><term>Dose-Response Relationship, Drug</term><term>Dystonia (drug therapy)</term><term>Electromyography</term><term>Facial Muscles (drug effects)</term><term>Female</term><term>Focal dystonias</term><term>Follow-Up Studies</term><term>Hemifacial spasm</term><term>Humans</term><term>Injections, Intramuscular</term><term>Injections, Subcutaneous</term><term>Male</term><term>Middle Aged</term><term>Spasm (drug therapy)</term><term>Spastic dysphonia</term><term>Torticollis</term><term>Torticollis (drug therapy)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Botulinum Toxins</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Facial Muscles</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Blepharospasm</term><term>Dystonia</term><term>Spasm</term><term>Torticollis</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Dose-Response Relationship, Drug</term><term>Electromyography</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Injections, Intramuscular</term><term>Injections, Subcutaneous</term><term>Male</term><term>Middle Aged</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Medical treatment of dystonia usually results in an incomplete response and is frequently unsuccessful. Peripheral surgical therapy is available for some focal dystonias, but may only offer temporary relief and may have unacceptable complications. We have used local injections of botulinum toxin into the appropriate muscles for treatment of disabling focal or segmental dystonia in 93 patients with torticollis, blepharospasm, oromandibular dystonia (OMD), limb dystonia, lingual dystonia, and dystonia adductor dysphonia, in addition to four patients with hemifacial spasm. Significant relief of motor symptoms was seen in 69% of the patients with blepharospasm and 64% of patients with torticollis; 74% of the latter group with pain experience relief. Relief of symptoms was noted in most patients with OMD and limb dystonia, and all with lingual dystonia, dystonic adductor spastic dysphonia, and those with hemifacial spasm. Benefit averaged 2½‐3 months initially; however some patients experienced longer relief with subsequent injections. Adverse effects were transient, although 2 patients developed antibodies against the toxin, and we documented evidence for distant effects in others. This approach of chemically weakening contracting muscles in focal dystonia offers many advantages over pharmacotherapy and surgical therapy. Additional experience is needed to explore the proper doses, and potential for long term adverse effects.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>État de New York</li></region></list><tree><country name="États-Unis"><region name="État de New York"><name sortKey="Brin" sort="Brin" uniqKey="Brin" last="Brin">Brin</name></region><name sortKey="Blitzer, Andrew" sort="Blitzer, Andrew" uniqKey="Blitzer A" first="Andrew" last="Blitzer">Andrew Blitzer</name><name sortKey="Fahn, Stanley" sort="Fahn, Stanley" uniqKey="Fahn S" first="Stanley" last="Fahn">Stanley Fahn</name><name sortKey="Friedman, Andrzej" sort="Friedman, Andrzej" uniqKey="Friedman A" first="Andrzej" last="Friedman">Andrzej Friedman</name><name sortKey="Greene, Paul E" sort="Greene, Paul E" uniqKey="Greene P" first="Paul E." last="Greene">Paul E. Greene</name><name sortKey="Lange, Dale" sort="Lange, Dale" uniqKey="Lange D" first="Dale" last="Lange">Dale Lange</name><name sortKey="List, Theodore" sort="List, Theodore" uniqKey="List T" first="Theodore" last="List">Theodore List</name><name sortKey="Lovelace, Robert E" sort="Lovelace, Robert E" uniqKey="Lovelace R" first="Robert E." last="Lovelace">Robert E. Lovelace</name><name sortKey="Mcmahon, Don" sort="Mcmahon, Don" uniqKey="Mcmahon D" first="Don" last="Mcmahon">Don Mcmahon</name><name sortKey="Moskowitz, Carol" sort="Moskowitz, Carol" uniqKey="Moskowitz C" first="Carol" last="Moskowitz">Carol Moskowitz</name><name sortKey="Shale, Heidi M" sort="Shale, Heidi M" uniqKey="Shale H" first="Heidi M." last="Shale">Heidi M. Shale</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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