title: Long-term botulinum toxin treatment of focal hand dystonia.
abstract: We treated focal hand dystonia in 53 patients with botulinum toxin injections for up to 6 years. Eighty-one percent of the patients improved with at least one injection session. Sixty-five percent of the injections produced transient weakness. We followed 37 of the patients for at least 2 years from the start of treatment, 24 of whom discontinued treatment because of inadequate response, loss of response, inaccessibility of a treatment provider, or the expense of the toxin. Women, who had a greater extent and longer duration of benefit than men, were more likely to continue treatment. The mean interval between injection sessions was 6 months. In most patients, we injected the toxin into the same combination of muscles at each session. The dose of toxin generally fluctuated within a range of 20 units. Side effects were mild and transient and unrelated to the long-term use of botulinum toxin. Botulinum toxin injection is safe and effective for the long-term management of focal hand dystonia.
authors.affiliation: Human Motor Control Section, NINDS, NIH, Bethesda, MD 20892.
authors.forename: B I
authors.initials: BI
authors.lastname: Karp
authors.forename: R A
authors.initials: RA
authors.lastname: Cole
authors.forename: L G
authors.initials: LG
authors.lastname: Cohen
authors.forename: S
authors.initials: S
authors.lastname: Grill
authors.forename: J S
authors.initials: JS
authors.lastname: Lou
authors.forename: M
authors.initials: M
authors.lastname: Hallett
mesh_terms: D000328:Adult; D000368:Aged; D001905:Botulinum Toxins / Q000008:administration & dosage / Q000627:therapeutic use*; D004421:Dystonia / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009120:Muscle Cramp / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001905:Botulinum Toxins