Treatment of phonic tics in patients with Tourette's syndrome using botulinum toxin type A.
We assessed the effect of botulinum toxin type A (BTX-A) on phonic tics in patients with Tourette's syndrome. A total of 30 patients received 2.5 IU BTX-A (BOTOX; Allergan) in both vocal cords. All patients were assessed after 15 days and then 4 times over a 12-month period. At each visit the following data were collected: phenomenology of tics, global impression of changes by physician and patient, number of BTX-A injections given, interval between injections, time to response, duration of response, presence of post-injection hypophonia and side effects, presence of premonitory sensory tic component, and interference with social life and work or school activities. Vocal tics improved after treatment in 93% patients, with 50% being tic-free. Mean response time was 5.8 days, and mean duration of response was 102 days. Quality of life improved, and premonitory experiences dropped from 53% to 20%. Hypophonia was the only side effect of note (80% of patients). BTX-A is an effective and safe treatment for phonic tics associated with Tourette's syndrome.
Porta
M
M
Department of Neurology, Policlinico San Marco, Zingonia (BG), Italy. prof.porta@inwind.it
Maggioni
G
G
Ottaviani
F
F
Schindler
A
A
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002648:Child; D004576:Electromyography / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D020323:Tics / Q000145:classification / Q000188:drug therapy* / Q000209:etiology; D005879:Tourette Syndrome / Q000150:complications; D016896:Treatment Outcome; D014827:Vocal Cords / Q000187:drug effects
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A