title: Long-term efficacy and safety of botulinum toxin injections in dystonia.
abstract: Local chemodenervation with botulinum toxin (BoNT) injections to relax abnormally contracting muscles has been shown to be an effective and well-tolerated treatment in a variety of movement disorders and other neurological and non-neurological disorders. Despite almost 30 years of therapeutic use, there are only few studies of patients treated with BoNT injections over long period of time. These published data clearly support the conclusion that BoNT not only provides safe and effective symptomatic relief of dystonia but also long-term benefit and possibly even favorably modifying the natural history of this disease. The adverse events associated with chronic, periodic exposure to BoNT injections are generally minor and self-limiting. With the chronic use of BoNT and an expanding list of therapeutic indications, there is a need to carefully examine the existing data on the long-term efficacy and safety of BoNT. In this review we will highlight some of the aspects of long-term effects of BoNT, including efficacy, safety, and immunogenicity.
authors: Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA. jlcastan@bcm.edu
authors: Juan
authors: J
authors: Ramirez-Castaneda
authors: Joseph
authors: J
authors: Jankovic
mesh_terms: D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D001905:Botulinum Toxins / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D004421:Dystonia / Q000188:drug therapy*; D006801:Humans; D007267:Injections; D016896:Treatment Outcome
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins
references: J Neurol Neurosurg Psychiatry. 2004 Jul;75(7):951-7
references: 15201348
references: Exp Neurol. 1997 Sep;147(1):96-102
references: 9294406
references: Am J Ophthalmol. 2003 Jul;136(1):99-105
references: 12834676
references: J Neurol. 2003 Aug;250(8):967-9
references: 12928917
references: Mov Disord. 2000 Jan;15(1):150-3
references: 10634256
references: Parkinsonism Relat Disord. 2010 Jun;16(5):316-23
references: 20359934
references: Clin Neuropharmacol. 2012 Sep-Oct;35(5):215-23
references: 22932474
references: Mov Disord. 2011 Jun;26(7):1282-9
references: 21469207
references: Mov Disord. 2005 Jul;20(7):783-91
references: 15736159
references: Neurotox Res. 2012 Nov;22(4):265-73
references: 22359151
references: Neurology. 1999 Dec 10;53(9):2102-7
references: 10599789
references: Neurology. 1993 Apr;43(4):834-6
references: 8469349
references: Neuropsychiatr Dis Treat. 2012;8:13-25
references: 22275842
references: Mov Disord. 2005 May;20(5):592-7
references: 15645481
references: Mov Disord. 2008 Jul 30;23(10):1353-60
references: 18546321
references: J Neural Transm (Vienna). 2013 Feb;120(2):299-307
references: 22878514
references: Eye (Lond). 2010 Apr;24(4):600-7
references: 19648904
references: Toxicon. 2001 Dec;39(12):1815-20
references: 11600142
references: BMC Neurol. 2011 Nov 04;11:140
references: 22054223
references: Neurology. 1995 Sep;45(9):1743-6
references: 7675238
references: Neurology. 1987 Apr;37(4):616-23
references: 3561773
references: Cochrane Database Syst Rev. 2005 Jan 25;(1):CD004900
references: 15674969
references: Clin J Pain. 2002 Nov-Dec;18(6 Suppl):S133-41
references: 12569960
references: Neurology. 2003 Apr 8;60(7):1186-8
references: 12682332
references: Neurol Res. 2009 Jun;31(5):463-6
references: 19278576
references: Mov Disord. 2011 Mar;26(4):750-3
references: 21506157
references: Toxins (Basel). 2013 Feb 04;5(2):249-66
references: 23381141
references: Can J Neurol Sci. 1985 Nov;12(4):314-6
references: 4084867
references: Lancet Neurol. 2006 Oct;5(10):864-72
references: 16987733
references: Mov Disord. 2002 Nov;17(6):1288-93
references: 12465070
references: J Neurol. 1999 Apr;246(4):265-74
references: 10367694
references: Neurology. 2006 Dec 26;67(12):2233-5
references: 17190952
references: Curr Neurol Neurosci Rep. 2012 Aug;12(4):399-409
references: 22661378
references: J Neuroimmunol. 2011 Aug 15;237(1-2):66-72
references: 21737146
references: Clin Neuropharmacol. 2012 Sep-Oct;35(5):208-14
references: 22948497
references: Eur J Neurol. 2005 Mar;12(3):163-70
references: 15693803
references: Mov Disord. 2004 Mar;19(3):303-8
references: 15022184
references: Neurotox Res. 2009 Apr;15(3):224-31
references: 19384595
references: Neurology. 2005 Jan 25;64(2):341-3
references: 15668436
references: Mov Disord. 1998 Jan;13(1):150-4
references: 9452341
references: Toxicon. 2009 Oct;54(5):614-23
references: 19073203
references: Lancet. 1986 Aug 2;2(8501):245-7
references: 2874278
references: Clin Neuropharmacol. 2007 Mar-Apr;30(2):86-94
references: 17414940
references: Neurotox Res. 2006 Apr;9(2-3):145-8
references: 16785112
references: Mov Disord. 2005 Feb;20(2):233-7
references: 15455449