title: Treatment of proximal upper limb tremor with botulinum toxin therapy.
abstract: BACKGROUND
  Proximal-dominant upper limb tremor is highly disabling, and there is no effective medical therapy. In this study, we evaluated the efficacy of botulinum toxin (BTX) injections for the treatment of proximal tremor.
  
  
  METHODS
  We conducted a retrospective analysis of open-label treatment with BTX in 19 patients with proximal tremor. The response to therapy was graded into four categories according to self-reported improvements in tremor and function.
  
  
  RESULTS
  In total, 63% of patients reported moderate or marked benefit, defined as functional improvements sufficient enough to allow feeding or drinking from a cup; whereas 21% of patients reported mild benefit; and 15% of patients reported no benefit. One patient developed severe weakness of shoulder abduction and withdrew from the treatment; otherwise, the therapy was free of side effects.
  
  
  CONCLUSIONS
  The current findings support the efficacy of BTX therapy in the treatment of proximal upper limb tremor with minimal side effects.
authors: Movement Disorders Unit, Department of Neurology, Westmead Hospital, Sydney, New South Wales, Australia.
authors: Samuel D
authors: SD
authors: Kim
authors: Con
authors: C
authors: Yiannikas
authors: Neil
authors: N
authors: Mahant
authors: Steve
authors: S
authors: Vucic
authors: Victor S C
authors: VS
authors: Fung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001905:Botulinum Toxins / Q000627:therapeutic use*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009498:Neurotoxins / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D014202:Tremor / Q000188:drug therapy*; D034941:Upper Extremity / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D009498:Neurotoxins; D001905:Botulinum Toxins
keywords: botulinum toxin; proximal tremor; wing-beating tremor