title: Botulinum toxin type A in simple motor tics: short-term and long-term treatment-effects.
abstract: To determine the short-term and long-term treatment-effects of botulinum toxin type A in simple motor tics, we analyzed 15 consecutive patients (18 tics) with simple motor tics that were treated every 3 months with injections of BTX-A. Efficacy (rated on a 4-level scale) and duration of effect of the first 2 and last 2 (if treated 5 times or more) treatments were recorded, as well as latency of response, changes of premonitory urges (PMUs) and possible side effects. Total number of treatments for each tic varied from 2 to 50 (mean 11, median 6). In 16 of 18 tics (89%) short-term efficacy was reported successful (good or moderate). Long-term efficacy was reported in 12 tics of which 11 showed similar or even increased beneficial effects. Premonitory urge (PMU) was reported in 8 patients (53%). PMU, if present, lessened or disappeared after treatment with BTX-A. A permanent remission of the treated tic was seen in 3 patients with a maximum follow-up of 10 years. BTX-A appears a safe and effective treatment for simple motor tics and retains its efficacy after long-term treatment. BTX may also induce permanent remission of the treated tics and effects of BTX are not restricted to merely motor behaviour.
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Haga Hospital, Leyweg 275, The Hague, The Netherlands. jjgrath@hotmail.com
authors.forename: Judith J G
authors.initials: JJ
authors.lastname: Rath
authors.forename: Dénes L J
authors.initials: DL
authors.lastname: Tavy
authors.forename: Agnes A A C M
authors.initials: AA
authors.lastname: Wertenbroek
authors.forename: Theodoor C A M
authors.initials: TC
authors.lastname: van Woerkom
authors.forename: Sebastiaan F T M
authors.initials: SF
authors.lastname: de Bruijn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011930:Reaction Time / Q000187:drug effects; D012189:Retrospective Studies; D020323:Tics / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A