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Mexiletine in the treatment of spasmodic torticollis.

Identifieur interne : 004308 ( PubMed/Curation ); précédent : 004307; suivant : 004309

Mexiletine in the treatment of spasmodic torticollis.

Auteurs : S. Ohara [Japon] ; R. Hayashi ; H. Momoi ; J. Miki ; N. Yanagisawa

Source :

Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1998.

RBID : pubmed:9827618

English descriptors

KwdEn :
- Administration, Oral, Adult, Analysis of Variance, Anesthetics, Local (therapeutic use), Dystonia (drug therapy), Electromyography, Female, Humans, Infusions, Intravenous, Lidocaine (therapeutic use), Male, Mexiletine (therapeutic use), Middle Aged, Questionnaires, Torticollis (drug therapy).
MESH :
- chemical , therapeutic use : Anesthetics, Local, Lidocaine, Mexiletine.
- drug therapy : Dystonia, Torticollis.
- Administration, Oral, Adult, Analysis of Variance, Electromyography, Female, Humans, Infusions, Intravenous, Male, Middle Aged, Questionnaires.

Abstract

We studied the clinical efficacy of mexiletine, a derivative oral form of lidocaine, for treatment of spasmodic torticollis. One of the nine subjects of this study was previously reported. Before starting oral mexiletine, normal saline was first injected intravenously as placebo control; lidocaine infusion then followed and clinical evaluation was provided by dystonia rating scale scores, videotape recordings, and surface electromyographic recording. In all patients, lidocaine injection resulted in a decrease of dystonic muscle contractions within 5 minutes and the effect lasted approximately 1 hour. With gradual increase of mexiletine dose, similar clinical improvement was obtained with oral doses ranging from 450-1200 mg/day for more than 6 months. Side effects in six of nine patients included upper gastrointestinal symptoms, dizziness, ataxia, and dysarthria. These were tolerable or medically manageable; only one patient required a small reduction in mexiletine dose. Strong positive correlation was found between serum and cerebrospinal fluid (CSF) mexiletine concentrations with a CSF/serum ratio of 0.6 (r = 0.96, p = 0.0005) suggesting its effective penetrance into the central nervous system. We suggest that oral mexiletine therapy may be a safe and effective treatment for spasmodic torticollis.

DOI: 10.1002/mds.870130612
PubMed: 9827618

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pubmed:9827618

Le document en format XML

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<author><name sortKey="Ohara, S" sort="Ohara, S" uniqKey="Ohara S" first="S" last="Ohara">S. Ohara</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, National Chushin-Matsumoto Hospital, Matsumoto, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Neurology, National Chushin-Matsumoto Hospital, Matsumoto</wicri:regionArea>
</affiliation>
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<author><name sortKey="Hayashi, R" sort="Hayashi, R" uniqKey="Hayashi R" first="R" last="Hayashi">R. Hayashi</name>
</author>
<author><name sortKey="Momoi, H" sort="Momoi, H" uniqKey="Momoi H" first="H" last="Momoi">H. Momoi</name>
</author>
<author><name sortKey="Miki, J" sort="Miki, J" uniqKey="Miki J" first="J" last="Miki">J. Miki</name>
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<author><name sortKey="Yanagisawa, N" sort="Yanagisawa, N" uniqKey="Yanagisawa N" first="N" last="Yanagisawa">N. Yanagisawa</name>
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<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, National Chushin-Matsumoto Hospital, Matsumoto, Japan.</nlm:affiliation>
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<term>Adult</term>
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<term>Anesthetics, Local (therapeutic use)</term>
<term>Dystonia (drug therapy)</term>
<term>Electromyography</term>
<term>Female</term>
<term>Humans</term>
<term>Infusions, Intravenous</term>
<term>Lidocaine (therapeutic use)</term>
<term>Male</term>
<term>Mexiletine (therapeutic use)</term>
<term>Middle Aged</term>
<term>Questionnaires</term>
<term>Torticollis (drug therapy)</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Dystonia</term>
<term>Torticollis</term>
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<keywords scheme="MESH" xml:lang="en"><term>Administration, Oral</term>
<term>Adult</term>
<term>Analysis of Variance</term>
<term>Electromyography</term>
<term>Female</term>
<term>Humans</term>
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<front><div type="abstract" xml:lang="en">We studied the clinical efficacy of mexiletine, a derivative oral form of lidocaine, for treatment of spasmodic torticollis. One of the nine subjects of this study was previously reported. Before starting oral mexiletine, normal saline was first injected intravenously as placebo control; lidocaine infusion then followed and clinical evaluation was provided by dystonia rating scale scores, videotape recordings, and surface electromyographic recording. In all patients, lidocaine injection resulted in a decrease of dystonic muscle contractions within 5 minutes and the effect lasted approximately 1 hour. With gradual increase of mexiletine dose, similar clinical improvement was obtained with oral doses ranging from 450-1200 mg/day for more than 6 months. Side effects in six of nine patients included upper gastrointestinal symptoms, dizziness, ataxia, and dysarthria. These were tolerable or medically manageable; only one patient required a small reduction in mexiletine dose. Strong positive correlation was found between serum and cerebrospinal fluid (CSF) mexiletine concentrations with a CSF/serum ratio of 0.6 (r = 0.96, p = 0.0005) suggesting its effective penetrance into the central nervous system. We suggest that oral mexiletine therapy may be a safe and effective treatment for spasmodic torticollis.</div>
</front>
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<Title>Movement disorders : official journal of the Movement Disorder Society</Title>
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<ArticleTitle>Mexiletine in the treatment of spasmodic torticollis.</ArticleTitle>
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<Abstract><AbstractText>We studied the clinical efficacy of mexiletine, a derivative oral form of lidocaine, for treatment of spasmodic torticollis. One of the nine subjects of this study was previously reported. Before starting oral mexiletine, normal saline was first injected intravenously as placebo control; lidocaine infusion then followed and clinical evaluation was provided by dystonia rating scale scores, videotape recordings, and surface electromyographic recording. In all patients, lidocaine injection resulted in a decrease of dystonic muscle contractions within 5 minutes and the effect lasted approximately 1 hour. With gradual increase of mexiletine dose, similar clinical improvement was obtained with oral doses ranging from 450-1200 mg/day for more than 6 months. Side effects in six of nine patients included upper gastrointestinal symptoms, dizziness, ataxia, and dysarthria. These were tolerable or medically manageable; only one patient required a small reduction in mexiletine dose. Strong positive correlation was found between serum and cerebrospinal fluid (CSF) mexiletine concentrations with a CSF/serum ratio of 0.6 (r = 0.96, p = 0.0005) suggesting its effective penetrance into the central nervous system. We suggest that oral mexiletine therapy may be a safe and effective treatment for spasmodic torticollis.</AbstractText>
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<MeshHeading><DescriptorName MajorTopicYN="N" UI="D008875">Middle Aged</DescriptorName>
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<MeshHeading><DescriptorName MajorTopicYN="N" UI="D011795">Questionnaires</DescriptorName>
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	Movement Disorders (revue)
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Movement Disorders (revue)

Mexiletine in the treatment of spasmodic torticollis.

Mexiletine in the treatment of spasmodic torticollis.

Source :

English descriptors

Abstract

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