Movement Disorders and Therapeutic Applications of Botulinum Toxin

A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Bacterial Toxins".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 7671

Special Issue Editors


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Guest Editor
Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, MD 20892, USA

E-Mail Website
Guest Editor
Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, MD 20892, USA

Special Issue Information

Dear Colleagues,

Movement disorders were among the earliest therapeutic uses of botulinum toxin. There is now over 30 years’ experience with botulinum toxin treatment of dystonic disorders, including blepharospasm, cervical dystonia, and focal had dystonia, as well as other neurologic conditions, such as hemifacial spasm, tremor, and spasticity. The use of BoNT for neurosecretory disorders has expanded, including the treatment of sialorrhea which is often seen in association with a movement disorder. A number of these conditions lack other effective treatments, making botulinum toxin a first-line therapy. The number of applications continues to evolve along with increasing understanding of botulinum toxin’s physiologic effects centrally and peripherally and its mechanism of action in treating movement disorders. The methodology of administering botulinum toxin is similarly progressing.

This Special Issue will focus on the current status of botulinum toxin for the treatment of movement disorders (encompassing focal, generalized and secondary dystonias, tremor, ataxia, tics, and chorea), sialorrhea, as well as technical approaches to botulinum toxin usage, including issues such as dosing, guidance techniques, and target muscle selection.

Dr. Barbara I. Karp
Dr. Katharine Alter
Guest Editors

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Keywords

  • botulinum toxin
  • dystonia
  • spasticity
  • cervical dystonia
  • focal hand dystonia
  • tics
  • tremor
  • onabotulinumtoxinA
  • abobotulinumtoxinA
  • incobotulinumtoxinA
  • rimabotulinumtoxinB

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Published Papers (2 papers)

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Research

10 pages, 2074 KiB  
Communication
Effective Treatment of Neurological Symptoms with Normal Doses of Botulinum Neurotoxin in Wilson’s Disease: Six Cases and Literature Review
by Harald Hefter and Sara Samadzadeh
Toxins 2021, 13(4), 241; https://doi.org/10.3390/toxins13040241 - 29 Mar 2021
Cited by 6 | Viewed by 2413
Abstract
Recent cell-based and animal experiments have demonstrated an effective reduction in botulinum neurotoxin A (BoNT/A) by copper. Aim: We aimed to analyze whether the successful symptomatic BoNT/A treatment of patients with Wilson’s disease (WD) corresponds with unusually high doses per session. Among the [...] Read more.
Recent cell-based and animal experiments have demonstrated an effective reduction in botulinum neurotoxin A (BoNT/A) by copper. Aim: We aimed to analyze whether the successful symptomatic BoNT/A treatment of patients with Wilson’s disease (WD) corresponds with unusually high doses per session. Among the 156 WD patients regularly seen at the outpatient department of the university hospital in Düsseldorf (Germany), only 6 patients had been treated with BoNT/A during the past 5 years. The laboratory findings, indications for BoNT treatment, preparations, and doses per session were extracted retrospectively from the charts. These parameters were compared with those of 13 other patients described in the literature. BoNT/A injection therapy is a rare (<4%) symptomatic treatment in WD, only necessary in exceptional cases, and is often applied only transiently. In those cases for which dose information was available, the dose per session and indication appear to be within usual limits. Despite the evidence that copper can interfere with the botulinum toxin in preclinical models, patients with WD do not require higher doses of the toxin than other patients with dystonia. Full article
(This article belongs to the Special Issue Movement Disorders and Therapeutic Applications of Botulinum Toxin)
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10 pages, 1354 KiB  
Article
Management of Anterocapitis and Anterocollis: A Novel Ultrasound Guided Approach Combined with Electromyography for Botulinum Toxin Injection of Longus Colli and Longus Capitis
by Michael Farrell, Barbara I. Karp, Panagiotis Kassavetis, William Berrigan, Simge Yonter, Debra Ehrlich and Katharine E. Alter
Toxins 2020, 12(10), 626; https://doi.org/10.3390/toxins12100626 - 30 Sep 2020
Cited by 8 | Viewed by 4729
Abstract
Chemodenervation of cervical musculature using botulinum neurotoxin (BoNT) is established as the gold standard or treatment of choice for management of Cervical Dystonia (CD). The success of BoNT procedures is measured by improved symptomology while minimizing side effects and is dependent upon many [...] Read more.
Chemodenervation of cervical musculature using botulinum neurotoxin (BoNT) is established as the gold standard or treatment of choice for management of Cervical Dystonia (CD). The success of BoNT procedures is measured by improved symptomology while minimizing side effects and is dependent upon many factors including: clinical pattern recognition, identifying contributory muscles, BoNT dosage, and locating and safely injecting target muscles. In patients with CD, treatment of anterocollis (forward flexion of the neck) and anterocaput (anterocapitis) (forward flexion of the head) are inarguably challenging. The longus Colli (LoCol) and longus capitis (LoCap) muscles, two deep cervical spine and head flexor muscles, frequently contribute to these patterns. Localizing and safely injecting these muscles is particularly challenging owing to their deep location and the complex regional anatomy which includes critical neurovascular and other structures. Ultrasound (US) guidance provides direct visualization of the LoCol, LoCap, other cervical muscles and adjacent structures reducing the risks and side effects while improving the clinical outcome of BoNT for these conditions. The addition of electromyography (EMG) provides confirmation of muscle activity within the target muscle. Within this manuscript, we present a technical description of a novel US guided approach (combined with EMG) for BoNT injection into the LoCol and LoCap muscles for the management of anterocollis and anterocaput in patients with CD. Full article
(This article belongs to the Special Issue Movement Disorders and Therapeutic Applications of Botulinum Toxin)
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