title: Safety of botulinum toxin for dysphagia in oculopharyngeal muscular dystrophy.
abstract: BACKGROUND
  Despite multiple studies reporting marked benefit of botulinum toxin (BTX) for treatment of cricopharyngeal dysphagia, little is known about its safety for this indication. We examined the safety of cricopharyngeal BTX for dysphagia in oculopharyngeal muscular dystrophy (OPMD).
  
  
  METHODS
  We reviewed records of patients with OPMD who received cricopharyngeal BTX.
  
  
  RESULTS
  Twenty-four patients underwent 66 procedures. Overall adverse event frequency was 44%. The most common adverse events were dysphonia (24%) and worsened dysphagia (14%). Logistic regression demonstrated that dose was a significant predictor of worsened dysphagia (P = 0.036) and of the composite event of dysphonia or worsened dysphagia (P = 0.009). There was a nonsignificant trend for dose as a predictor of dysphonia (P = 0.073). 59% of procedures were associated with symptomatic improvement.
  
  
  CONCLUSIONS
  While BTX appears to be beneficial for treatment of dysphagia in OPMD, caution is warranted when injecting the cricopharyngeus muscle due to dose-related risk of dysphonia or worsened dysphagia.
authors.affiliation: Department of Neurology, MSC 10 5620, 1 University of New Mexico, Albuquerque, New Mexico, 87131.
authors.forename: Sarah
authors.initials: S
authors.lastname: Youssof
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Schrader
authors.forename: Carol
authors.initials: C
authors.lastname: Romero-Clark
authors.forename: Gulmohor
authors.initials: G
authors.lastname: Roy
authors.forename: Michael
authors.initials: M
authors.lastname: Spafford
mesh_terms: D000368:Aged; D001905:Botulinum Toxins / Q000008:administration & dosage* / Q000009:adverse effects*; D003680:Deglutition Disorders / Q000188:drug therapy* / Q000453:epidemiology; D055154:Dysphonia / Q000139:chemically induced; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D039141:Muscular Dystrophy, Oculopharyngeal / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D001905:Botulinum Toxins
keywords: botulinum toxin; dysphagia; neuromuscular diseases; oculopharyngeal muscular dystrophy; therapeutics