title: Botulinum toxins in the treatment of primary focal dystonias.
abstract: Focal dystonia, such as cervical dystonia, blepharospasm, oromandibular dystonia, laryngeal dystonia, and limb dystonia, is often observed in adult-onset primary dystonia syndromes that affect a specific area of the body and tend to have little or no spread. This review will examine the past, present, and future approaches to the treatment of focal dystonia. Botulinum toxin (BoNT) has emerged as the treatment of choice for the majority of focal dystonias. Currently four products are widely available commercially, three of BoNT/A type and one of BoNT/B type. Each has important pharmacological differences that give rise to markedly different dosing recommendations. The four approved BoNTs are safe and effective for treating focal dystonias, including long-term treatment. Adverse events are limited and transient and, for the most part, mild in severity. Potential problems with the use of BoNT agents are diffusion and neutralizing antibody formation; the latter can lead to treatment resistance. Because each BoNT product is developed from distinct purification and manufacturing procedures and has varying toxin complex size and structures, physicians need to be aware of these differences when choosing an agent.
authors.affiliation: Parkinson's and Movement Disorder Institute, 9940 Talbert Avenue, Suite 204, Fountain Valley, CA 92708, USA. dtruong@pmdi.org
authors.forename: Daniel
authors.initials: D
authors.lastname: Truong
mesh_terms: D000818:Animals; D001905:Botulinum Toxins / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000379:methods; D020821:Dystonic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D016896:Treatment Outcome
chemical_list: C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A