Botulinum neurotoxin in cervical dystonia revisited — recent advances and unanswered questions

Sławek, Jarosław; Jost, Wolfgang H.

doi:10.5603/pjnns.a2021.0029

Cited by 6 publications

(3 citation statements)

References 44 publications

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“…Intramuscular botulinum toxin injections (BoNT) are the treatment of choice for motor symptoms in CD. However, BoNT treatment meets only limited patient satisfaction [6]. The therapeutic response becomes apparent within 1-2 weeks after the BoNT injection, with peak effects at approximately 4-6 weeks and a gradual decline thereafter [7,8].…”

Section: Introductionmentioning

confidence: 99%

KinesioTaping: impact on non-motor symptoms in cervical dystonia patients treated with botulinum toxin injection

Dec-Ćwiek

Sawczyńska

Porębska

et al. 2024

Neurol Neurochir Pol.

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Aim of the study. To assess whether combined therapy with botulinum toxin injections (BoNT) and KinesioTaping could be helpful in managing non-motor symptoms (NMS) of cervical dystonia (CD). Material and methods.Seventeen patients with CD were enrolled in this single-centre, prospective, evaluator-blinded, randomised, crossover trial. We compared three forms of treatment: BoNT treatment alone, or combined with KinesioTaping, or combined with ShamTaping. NMS were assessed using the 14-item self-reported questionnaire proposed by Klingelhoefer, the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI).Results. There were no significant differences between the groups concerning mean results of HADS and PSQI scales, or mean total number of NMS after the procedures. The mean change from baseline HADS and PSQI scores, and total number of NMS after the procedure, also did not differ significantly between groups. ShamTaping combined with BoNT significantly increased the prevalence of pain.Conclusions and clinical implications. Our study did not confirm the effectiveness of combined therapy of BoNT and Kine-sioTaping in the management of NMS in patients with CD. Due to a potential negative effect of improper taping on pain in CD, patients with CD should only experience KinesioTaping as an adjunctive therapy, and if it is performed by a trained, experienced physiotherapist.

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Section: Introductionmentioning

confidence: 99%

KinesioTaping: impact on non-motor symptoms in cervical dystonia patients treated with botulinum toxin injection

Dec-Ćwiek

Sawczyńska

Porębska

et al. 2024

Neurol Neurochir Pol.

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“…Cervical dystonia is an adult-onset focal dystonia causing involuntary movements of the neck, head, and shoulders [ 1 ]. Cervical dystonia is associated with high rates of musculoskeletal pain, impaired activities of daily living lower quality of life [ 2 , 3 , 4 , 5 ]. In the last decade, a new clinical classification scheme (the COL-CAP framework) has been utilized when evaluating cervical dystonia [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin Injections to the Obliquus Capitis Inferioris Muscle for Dynamic Cervical Dystonia Improves Subjective Patient Outcomes

Bessemer,

Jog

2024

Toxins

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The obliquus capitis inferioris (OCI) muscle is a significant driver of cervical dystonia with torticaput movements and a no–no head tremor. Limited data are available on the efficacy of OCI injections on patient outcomes. Our study aims to determine whether the botulinum toxin injection into OCI improves subjective patient quality of life in those with dystonic head tremors. A retrospective chart review was performed for 25 patients receiving injections into the OCI for a dystonic head tremor at the London Movement Disorders Clinic between January 2020 and January 2022. Toronto Western Spasmodic Torticollis Scale-2 (TWSTRS-2) subscale scores for disability and pain, TWSTRS-PSYCH scores, and the global impression of severity were extracted. The average TWSTRS-2 disability subscale change was −2.8 points (p < 0.003). The average TWSTRS-2 pain subscale change was −4.6 points (p < 0.003). The average TWSTRS-PSYCH score prior to injection was 5.6. After injection, the average score was 3.7 (p < 0.004). The patient self-reported average global impression of severity before injection was 7.0; after this, it was 4.2 (p < 0.0003). The OCI injection showed significant improvement in retrospective patient self-reported outcomes; it should be considered early in the treatment plan for cervical dystonia with a no–no head tremor.

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“…This may be caused by several factors including inaccurate diagnosis, primary or secondary resistance to treatment and invalid drug storage. Nevertheless, it seems that appropriate pattern classification, a physician’s experience, BoNT-A dose and precision of injections are the most important factors contributing to successful treatment of CD [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Does Ultrasound Guidance Improve the Effectiveness of Neurotoxin Injections in Patients with Cervical Dystonia? (A Prospective, Partially-Blinded, Clinical Study)

Tyślerowicz

Dulski

Gawryluk

et al. 2022

Toxins

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Aim: The aim of this study was to evaluate the efficacy of ultrasound guidance (US) in the treatment of cervical dystonia (CD) with botulinum neurotoxin type A (BoNT-A) injections in comparison to anatomical landmarks (AL). To date, US is routinely used in many centers, but others deny its usefulness. Materials and Methods: Thirty-five patients (12 males, 23 females) with a clinical diagnosis of CD were included in the study. Intramuscular administration of BoNT-A was performed using either US guidance, or with AL, in two separate therapeutic sessions. The efficacy of BoNT-A administration was assessed with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), Tsui modified scale, Craniocervical Dystonia Questionnaire (CDQ-24) and Clinical Global Impression—Improvement scale (CGI-I). Additionally, patients at therapeutic sessions were digitally recorded and evaluated by two blinded and independent raters. Results: A significant decrease in total TWSTRS, severity subscale TWSTRS, Tsui score, and CDQ-24 was found in both the AL and US group; however, in the TWSTRS disability and pain subscales, a significant decrease was found only in the US group. Moreover, US guided treatment also resulted in a greater decrease in TWSTRS, Tsui score and CDQ-24 compared to anatomical landmarks use only. Conclusions: US guidance might be helpful in improving the results of BoNT-A injections in cervical dystonia, reducing associated pain and disability; however, more studies are needed to evaluate its clinical efficacy.

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Botulinum neurotoxin in cervical dystonia revisited — recent advances and unanswered questions

Cited by 6 publications

References 44 publications

KinesioTaping: impact on non-motor symptoms in cervical dystonia patients treated with botulinum toxin injection

KinesioTaping: impact on non-motor symptoms in cervical dystonia patients treated with botulinum toxin injection

Botulinum Toxin Injections to the Obliquus Capitis Inferioris Muscle for Dynamic Cervical Dystonia Improves Subjective Patient Outcomes

Does Ultrasound Guidance Improve the Effectiveness of Neurotoxin Injections in Patients with Cervical Dystonia? (A Prospective, Partially-Blinded, Clinical Study)

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