Botulinum Toxin as a Treatment for Blepharospasm, Spasmodic Torticollis and Hemifacial Spasm

Abstract

Fifty-two patients affected by focal dystonia or hemifacial spasm were treated with repeated injections of botulinum toxin. A clinical improvement was observed in all patients with blepharospasm; clinical benefit had a mean duration of 10 weeks. Clinical results were less inpressive, but also favorable in patients affected by spasmodic torticollis and by hemifacial spasm. In the latter, the incidence of drug-induced paresis was much higher than that observed in patients with blepharospasm, even though the doses of toxin injected were significantly lower.

Fifteen-Year Experience in Treating Blepharospasm with Botox or Dysport: Same Toxin, Two Drugs

“…Most treatments (55%) led to a clear benefit within 3 days. The rate of successful treatments ranged in previous series from 47.8% (Nussgens and Roggenkamper 1997) to 100% (Shorr et al 1985;Albanese et al 1992) whereas the rate in our series (93.3% of sessions), overlaps the most frequently reported rates, ranging from 90 to 96% (Dutton and Buckley, 1988;Jankovic et al 1990;Hsiung et al 2002;Silveira-Moriyama et al 2005). Duration of benefit in this series is comparable with the previously reported data (Frueh et al 1984;Brin et al 1987;Ruusuvaara and Setälä 1990;Mauriello and Aijian 1991;Ainsworth and Kraft 1995;Mauriello et al 1996;Thussu et al 1999;Cakmur et al 2002): indeed, the mean duration of action in all the studies was estimated between 49 (Shorr et al 1985) and 126 days ( Van den Bergh et al 1995).…”

“…The orbicularis oculi muscle was injected (in orbital or pre-tarsal portion) in three or four points (medial and lateral side of upper and lower eyelids close to palpebral rim) (Albanese et al 1992). If hyperactive, the extra-orbicular muscles (e.g.…”

Remote Effects of Chronic Botulinum Toxin Treatment: Electrophysiologic Results Do Not Indicate Subclinical Remodelling of Noninjected Muscles

“…The authors did not mention duration of disease. Since BTA has a well-documented but transient chemodenervation effect in dystonia [1, 2, 3, 18], a direct relationship between cumulative dose and duration of disease is likely. This expected correlation is supported by our data.…”

“…Repeated intramuscular injections of botulinum toxin type A (BTA) are regarded a safe and effective therapy of focal dystonia [1, 2, 3]. Partial chemodenervation of the injected muscle results in a transient paresis [3, 4], but recovery of strength occurs within several weeks by sprouting of motor axons [5].…”

Botulinumtoxintherapie beim idiopathischen Torticollis spasmodicus

“…Tag post injectionem. Damit lag er im Bereich der in der Literatur recht einheitlich angegebe nen mittleren Latenzzeit von 4,8-8 Tagen [7,8,21,23]. Im ersten Fallbeispiel ist die Wirkdauer mit 10 Monaten ungewöhnlich lang.…”