title: Low-dose treatment of cervical dystonia, blepharospasm and facial hemispasm with albumin-diluted botulinum toxin type A under EMG guidance. An open label study.
abstract: Several studies support the hypothesis that low-dose botulinum toxin treatment may be as beneficial as high-dose regimen. Therefore, we studied 115 patients (aged 27-84; mean 58.0, SD = 12.9 years; 68% females, 32% males) suffering from cervical dystonia (n = 66), blepharospasm (n = 28), and facial hemispasm (n = 21) over a period of 2 years in an open label, non-controlled pilot study. Patients received low-dose treatment with botulinum toxin type A (Dysport((R))). The toxin was diluted in 20 ml of 0.1% albumin solution to arrive at a concentration of 25 MU/ml and injected under EMG control. Patients responded to the treatment about 1 week after injection (mean 7.3 days, SD = 4.6). The mean duration of beneficial effects was 11.7 weeks (SD = 5.6). Patients evaluated the clinical global improvement on a scale ranging from 0 to 4. For the whole population, the mean was 2.7 points (SD = 1.1). In none of the subjects could antibodies to botulinum toxin type A be detected, and only a few side effects were observed. In conclusion, low-dose therapy with botulinum toxin A merits further controlled studies.
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Medical School of Hannover, Germany. rollnik.jens@mh-hannover.de
authors.forename: J D
authors.initials: JD
authors.lastname: Rollnik
authors.forename: M
authors.initials: M
authors.lastname: Matzke
authors.forename: K
authors.initials: K
authors.lastname: Wohlfarth
authors.forename: R
authors.initials: R
authors.lastname: Dengler
authors.forename: H
authors.initials: H
authors.lastname: Bigalke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins; D001764:Blepharospasm / Q000188:drug therapy*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D004421:Dystonia / Q000188:drug therapy* / Q000503:physiopathology; D004576:Electromyography / Q000379:methods; D005152:Facial Muscles / Q000294:innervation; D005260:Female; D005500:Follow-Up Studies; D019569:Hemifacial Spasm / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010865:Pilot Projects
chemical_list: D000418:Albumins; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A