title: Clinical changes of cervical dystonia pattern in long-term botulinum toxin treated patients.
abstract: Cervical dystonia (CD) is a complex disorder but the response to long-term botulinum toxin (BTX) therapy is satisfactory in most cases. Bad results are attributed by some authors to changes in muscle activation. Our purpose is to verify if the change in head deviation affects negatively the response to BTX therapy in a long-term follow-up, and if there are any differences in clinical parameters of these patients in comparison to those with stable pattern. From a total of 88 patients evaluated at the Movement Disorders Clinics of Hospital das Clinicas - University of São Paulo School of Medicine between January 1993 and December 2005, 67 were included. In 24 (35.8%) change in pattern of CD was observed, in a medium follow-up period of 80 months. The time between onset of dystonia and the diagnosis of pattern change was 9.7 years. Comparing with patients with no changes in CD pattern, there were no significant statistical differences. Improvement of symptoms around 60% was reported in both groups. In conclusion, the change in head deviation observed in CD was not responsible for bad response to therapy with BTX and there were no significant differences between both groups.
authors: Movement Disorders Clinics, Department of Neurology, Hospital das Clinicas, University of São Paulo, School of Medicine, São Paulo, Brazil. maiafernanda@yahoo.com.br <maiafernanda@yahoo.com.br>
authors: Fernanda Martins
authors: FM
authors: Maia
authors: Aline Kozoroski
authors: AK
authors: Kanashiro
authors: Hsin Fen
authors: HF
authors: Chien
authors: Lílian Regina
authors: LR
authors: Gonçalves
authors: Egberto Reis
authors: ER
authors: Barbosa
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D013223:Statistics as Topic; D014103:Torticollis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A