Online citations, reference lists, and bibliographies.
← Back to Search

Localized Injections Of Botulinum Toxin For The Treatment Of Focal Dystonia And Hemifacial Spasm

M. Brin, S. Fahn, C. Moskowitz, A. Friedman, Heidi M. Shale, Paul E. Greene, A. Blitzer, Theodore List, D. Lange, Robert E. Lovelace, D. McMahon
Published 1987 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Share
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.
This paper references
10.1136/bmj.290.6485.1857
Effect of treatment with botulinum toxin on neurogenic blepharospasm.
J. Elston (1985)
10.1055/S-2008-1063861
Torsion Dystonia: Clinical Spectrum and Treatment
S. Fahn (1982)
10.1212/WNL.35.10.1499
Blepharospasm, Meige syndronfie, and hemifacial Spasm
J. Mauriello (1985)
Natural history of idiopathic torsion dystonia.
C. Marsden (1976)
10.1016/S0161-6420(86)33785-0
The use of botulinum toxin in the medical management of benign essential blepharospasm.
K. I. Perman (1986)
10.1159/000153560
Statistical testing in dermatoglyphic studies.
D. Lendrem (1985)
10.1002/MUS.880100610
Distant effects of local injection of botulinum toxin
D. Lange (1987)
10.1001/ARCHOPHT.1985.01050090057031
Hemifacial spasm treated with botulinum A toxin injection.
P. Savino (1985)
10.1136/jnnp.43.9.789
Delayed-onset dystonia in patients with "static" encephalopathy.
R. Burke (1980)
10.1212/WNL.33.10.1255
High dosage anticholinergic therapy in dystonia
S. Fahn (1983)
10.1016/0002-9394(85)90228-4
Treatment of blepharospasm with botulinum toxin.
E. A. Tsoy (1985)
10.1001/ARCHOPHT.1984.01040031184014
Treatment of blepharospasm with botulinum toxin. A preliminary report.
B. Frueh (1984)
10.1017/S031716710003540X
A pilot study on the use of botulinum toxin in spasmodic torticollis.
J. Tsui (1985)
10.1126/SCIENCE.785600
Botulinum toxin: mechanism of presynaptic blockade.
I. Kao (1976)
Distant effects of locally injected botulinum toxin: incidence and course.
D. Lange (1988)
10.1016/S0002-9394(14)77954-1
The use of botulinum toxin in blepharospasm.
N. Shorr (1985)
10.1212/WNL.36.4.545
Botulinum toxin for blepharospasm: single-fiber EMG studies
D. Sanders (1986)
10.1001/ARCHOPHT.1985.01050030043017
Botulinum A toxin injection as a treatment for blepharospasm.
A. Scott (1985)



This paper is referenced by
10.1111/j.1526-4610.2011.01990.x
OnabotulinumtoxinA for Treatment of Chronic Migraine: Pooled Analyses of the 56‐Week PREEMPT Clinical Program
S. Aurora (2011)
10.1007/BF00999994
EMG biofeedback treatment of torticollis: A controlled outcome study
M. Jahanshahi (1991)
10.1007/978-3-642-77064-7_6
Botulinumtoxin A in der Behandlung der zervikalen Dystonien
R. Benecke (1993)
10.1002/MDS.870110404
Treatment outcomes in cervical dystonia: A clinimetric study
R. Lindeboom (1996)
10.1111/j.1468-1331.2006.01442.x
Botulinum toxin therapy of hemifacial spasm: comparing different therapeutic preparations
K. Frei (2006)
10.1016/S0894-1130(00)80022-8
Differences in somatosensory hand organization in a healthy flutist and a flutist with focal hand dystonia: a case report.
N. Byl (2000)
10.1590/S1678-91992005000400003
Poison as cure: a clinical review of botulinum toxin as an invaluable drug
J. Bali (2005)
10.1046/J.1524-4725.2003.29120.X
Botulinum Toxin Type B (Myobloc)
L. Baumann (2003)
10.1155/2012/295251
Botulinum Toxin Injections for Simple Partial Motor Seizures Associated with Pain
E. Mader (2012)
10.1002/MDS.870040401
Adductor laryngeal dystonia (spastic dysphonia): Treatment with local injections of botulinum toxin (Botox)
M. Brin (1989)
10.1007/s00702-007-0832-3
Evidence based medicine on the use of botulinum toxin for headache disorders
W. Schulte-Mattler (2007)
10.1136/jnnp.52.Suppl.96
Clinical variants of idiopathic torsion dystonia.
S. Fahn (1989)
10.1007/978-3-642-85173-5_6
Clinical use of botulinum neurotoxins.
F. Cardoso (1995)
10.1016/S0163-7258(96)00091-5
Botulinum toxin as a therapeutic agent.
J. Tsui (1996)
10.1016/S1567-4231(09)70189-3
Chapter 41 Focal injection therapy
Jean-Michel Gracies (2003)
10.1016/J.JBMT.2005.12.001
Aberrant learning in individuals who perform repetitive skilled hand movements: Focal hand dystonia—Part 1
N. Byl (2006)
10.1111/j.1743-6109.2009.01434.x
Botulinum toxin a (Botox) for relieving penile retraction.
O. Shaeer (2009)
10.1111/ddg.12013
Konsensusempfehlungen zur Behandlung mit Onabotulinumtoxin A in der ästhetischen Medizin
W. Philipp-Dormston (2013)
10.1007/s00482-003-0203-4
Botulinum-Toxin in der speziellen Schmerztherapie
H. Goebel (2003)
10.21276/aohdr.1886
Botox: An Advancement In Dentistry – An Overview
Pragathi Raghavendra Bhat (2018)
10.1007/s00115-016-0250-6
Einsatz intra- bzw. subkutaner Botulinumtoxine bei Post-Zoster-Neuralgie
L. Halb (2016)
10.1136/jnnp.53.8.640
Botulinum toxin treatment in spasmodic torticollis.
J. Blackie (1990)
10.1016/0003-9969(91)90032-P
Ultrastructural changes in the masseter muscle of Macaca fascicularis resulting from intramuscular injections of botulinum toxin type A.
N. Capra (1991)
10.1007/BF00812153
Local botulinum toxin in the treatment of spastic drop foot
R. Dengler (2004)
10.1007/978-1-4757-9542-4_64
The Use of Botulinum Toxin in the Management of Cerebral Palsy in Pediatric Patients
L. Koman (1993)
10.1212/WNL.39.10.1404-a
Aid in writer's cramp
N. Quinn (1989)
10.1159/000062053
Surgery for Spasmodic Torticollis
A. Villavicencio (2000)
10.1046/J.1524-4725.2003.29183.X
Botulinum Toxin: Application Into Acupuncture Points for Migraine
B. Tamura (2003)
10.1016/J.MEHY.2007.01.037
Can botulinum toxin put the restless legs syndrome to rest?
E. Lim (2007)
Botulinum toxin injections for the treatment of spasmodic dysphonia (Review)
Watts Ccw (2007)
10.1016/S1283-0887(07)48907-1
Aspects thérapeutiques actuels de la toxine botulique en neurologie
S. Sangla (2007)
10.1111/j.1468-1331.2006.01443.x
Botulinum toxin therapy of laryngeal muscle hyperactivity syndromes: comparing different botulinum toxin preparations
D. Truong (2006)
See more
Semantic Scholar Logo Some data provided by SemanticScholar