Role of Botulinum Toxin in Treatment of Secondary Dystonia: A Case Series and Overview of Literature
Abstract
:1. Introduction
2. Discussion
3. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Subject | Etiology and Age at Onset | Dystonia Pattern | Dystonia Severity | Botulinum Toxin Therapy | Outcome |
---|---|---|---|---|---|
Male, 27 years; 79 kg | Wilson’s disease; 18 years | Cervical dystonia, blepharospasm, oromandibular dystonia, dystonia of both upper extremities | Neck: 3 Mouth: 4 Eyes: 3 Right arm: 3 Left arm: 4 | onabotulinumtoxinA 600 U (300 U CD, 80 U blepharospasm, 100 U OMD, 80 U R arm, 120 U Left arm × 3 cycles; abobotulinumtoxinA 1500 U (750 U CD, 50 U blepharospasm, 100 OMD, 200 U Right arm, 400 U Left arm × 8 cycles, ongoing therapy | onabotulinumtoxinA relief of dystonia for about 8 weeks; abobotulinumtoxinA relief of dystonia for about 10 weeks |
Female, 22 years; 64 kg | Wilson’s disease; 19 years | Cervical dystonia, dystonia of left arm and left leg | Neck: 3 Left arm: 4 Left leg: 3 | abobotulinumtoxinA 1500 U (500 U CD, 500 U each extremity) × 12 cycles, ongoing therapy | Improved CD, mild relief of limb dystonia lasting about 6 weeks |
Female, 21 years; 74 kg | Wilson’s disease; 18 years | Oromandibular dystonia; severe sialorrhea also present | Mouth: 3 | incobotulinumtoxinA 200 U (100 U OMD, 100 U sialorrhea) × 15 cycles, ongoing therapy | Improved OMD lasting 12 weeks |
Male, 22 years; 87 kg | Wilson’s disease; 17 years | Cervical dystonia, blepharospasm, oromandibular dystonia | Neck: 3 Mouth: 3 Eyes: 3 | onabotulinumtoxinA 500 U (300 U CD, 100 U blepharospasm, 100 U OMD, × 11 cycles | Improved CD, blepharospasm controlled for 11 weeks, mild relief of OMD lasting about 8 weeks |
Male, 36 years; 91 kg | Wilson’s disease; 24 years | Dystonia of both upper and lower extremities | Right arm: 3 Left arm: 2 Right leg: 3 Left leg: 2 | abobotulinumtoxinA 1500 U (500 U Right arm, 300 Right leg, 400 U arm, 300 U Left leg) × 10 cycles, ongoing therapy | Dystonia of all extremities improved for 9–10 weeks |
Male, 18 years; 74 kg | PKAN (Pantothenate kinase-associated neurodegeneration); 13 years | Oromandibular dystonia, dystonia of both upper and lower extremities | Mouth: 3 Right arm: 3 Left arm: 3 Right leg: 3 Left leg: 3 | onabotulinumtoxinA 600 U (100 U OMD, 200 U Right arm, 150 U Left arm, 75 U each leg) × 6 cycles | Mild and inconsistent improvement in all dystonic segments, lasting about 8 weeks |
Male, 19 years; 70 kg | PKAN (Pantothenate kinase-associated neurodegeneration); 11 years | Cervical dystonia, oromandibular dystonia, dystonia of both upper extremities and left leg | Mouth: 3 Neck: 3 Right arm: 4 Left arm: 3 Left leg: 2 | abobotulinumtoxinA 1500 U (500 U CD, 100 U OMD, 500 U Right arm, 200 U Right leg) × 9 cycles, ongoing therapy | Improved CD, blepharospasm controlled for 10 weeks, moderate improvement in OMD lasting about 8 weeks |
Female, 17 years; 53 kg | PKAN (Pantothenate kinase-associated neurodegeneration); 7 years | Cervical dystonia, oromandibular dystonia, dystonia of both upper extremities | Mouth: 3 Neck: 3 Right arm: 4 Left arm: 4 | abobotulinumtoxinA 1500 U (750 U CD, 150 U OMD, 300 U each arm) × 7 cycles | Improved CD, OMD for 10 weeks; mild improvement in arm dystonia lasting about 7–8 weeks |
Male, 22 years; 79 kg | Niemann–Pick type C; 15 years | Cervical dystonia | Neck: 3 | onabotulinumtoxinA 300 U (300 U CD) × 13 cycles, ongoing therapy | Marked improved CD for 11–12 weeks |
Male, 31 years; 92 kg | Niemann–Pick type C; 19 years | Cervical dystonia, blepharospasm | Neck: 3 Eyes: 2 | incobotulinumtoxinA 300 U (250 U CN, 50 U blepharospasm) × 14 cycles, ongoing therapy | Marked improved CD, blepharospasm for 11–12 weeks |
Female, 28 years; 59 kg | Sanfilippo syndrome (Mucopolysaccharidosis Type IIIb); 4 years | Cervical dystonia, dystonia of both upper extremities, severe sialorrhea also present | Neck: 3 Right arm: 2 Left arm: 2 | onabotulinumtoxinA 400 U (200 U CD, 100 U each arm) × 3 cycles rimabotulinumtoxinB 20,000 U (10,000 U CD, 5000 U sialorrhea, 5000 each arm) × 8 cycles, ongoing | onabotulinumtoxinA partial relief of dystonia for about 7 weeks; rimabotulinumtoxinB improved dystonia in every segment for 10 weeks |
Male, 19 years; 71 kg | Glutaric aciduria type 1; 2 years | Dystonia of all four extremities | Right arm: 3 Left arm: 2 Right leg: 3 Left leg: 3 | abobotulinumtoxinA 1500 U (500 U Right arm, 200 U Left arm, CD, 400 U each lower extremity) × 7 cycles, ongoing therapy | Mild improvement in dystonia in extremities for about 8–9 weeks |
Female, 18 years; 61 kg | Glutaric aciduria type; 12 years | Cervical dystonia, dystonia of both arms | Neck: 3 Right arm: 3 Left arm: 3 | onabotulinumtoxinA 600 U (200 U CD, 200 U each arm) × 11 cycles, ongoing therapy | Mild improvement in CD for 8 weeks; mild and inconsistent improvement in dystonia in extremities; dystonia lasting about 6–8 weeks |
Male, 19 years; 54 kg | GM2 Gangliosidosis (Sandhoff disease); 9 years | Cervical dystonia, oromandibular dystonia, severe sialorrhea also present | Mouth: 3 Neck: 3 | onabotulinumtoxinA 400 U (100 U OMD, 300 U CD) × 9 cycles, ongoing therapy | Mild improvement in OMD for 9 weeks; moderate improvement in CD for 10 weeks |
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Mohanty, D.; Riordan, H.R.M.; Hedera, P. Role of Botulinum Toxin in Treatment of Secondary Dystonia: A Case Series and Overview of Literature. Toxins 2024, 16, 286. https://doi.org/10.3390/toxins16070286
Mohanty D, Riordan HRM, Hedera P. Role of Botulinum Toxin in Treatment of Secondary Dystonia: A Case Series and Overview of Literature. Toxins. 2024; 16(7):286. https://doi.org/10.3390/toxins16070286
Chicago/Turabian StyleMohanty, Diksha, Heather R. M. Riordan, and Peter Hedera. 2024. "Role of Botulinum Toxin in Treatment of Secondary Dystonia: A Case Series and Overview of Literature" Toxins 16, no. 7: 286. https://doi.org/10.3390/toxins16070286