[Prognostic factors of long-standing improvement in cervical dystonia, treated with botulinum A toxin].
The clinical improvement after injections of botulinum toxin A in patients with idiopathic spasmodic torticollis lasts usually about 3 months. Nevertheless in some patients it exceeds several months. The aim of our study was to assess the frequency of prolonged response (arbitrally established as > 6 months) and to find the possible prognostic factors of such longer effect. In the group of 43 patients (F30, M13), average age 43.9 (19-72) years, we observed prolonged effect in 13 (30.2%). In 5 of them remission was repeated in following sessions (two times in four and four times in one). The frequency of spontaneous remissions in spasmodic torticollis (12%) is significantly lower than after botulinum toxin, what means that they are triggered by drug injection in our group of patients with prolonged effect. Within the analysed parameters only the lower average age and the average age at the onset of symptoms statistically significantly differ in both groups. The authors suggest the possibility of other mechanisms responsible for prolonged clinical effect after botulinum toxin: e.g. different time of reinnervation (remodelling of synapses) or the modification of natural course (feed-back mechanisms) of spasmodic torticollis in some patients.
Sławek
Jarosław
J
Wojewódzkiego Oddziału Neurologii Szpitala Specjalistycznego św, Wojciecha w Gdańsku.
Cielecka
Agata
A
Duzyński
Wojciech
W
D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014103:Torticollis / Q000188:drug therapy*; D016896:Treatment Outcome
D019274:Botulinum Toxins, Type A
Czynniki prognostyczne długotrwałej poprawy w dystonii szyjnej, leczonej toksyna botulinowa typu A.