Long-term follow-up of botulinum toxin therapy for focal hand dystonia: Outcome at 10 years or more

Authors

  • Codrin Lungu MD,,

    1. Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
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  • Barbara I. Karp MD,,

    1. Combined Neuroscience IRB, National Institutes of Health, Bethesda, Maryland, USA
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  • Katharine Alter MD,,

    1. Physical Disabilities Section, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
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  • Regina Zolbrod,,

    1. Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
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  • Mark Hallett MD

    Corresponding author
    1. Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
    • NIH Medical Neurology, Bldg 10, Rm 7D37, MSC 1428, 10 Center Dr, Bethesda, MD 20892, USA

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  • Relevant conflicts of interest/financial disclosures: Nothing to report Full financial disclosures and author roles can be found in the online version of this article.

Abstract

Background:

Previous studies have explored the efficacy and safety of botulinum neurotoxin (BoNT) treatment for Focal hand dystonia (FHD), but none have followed a large number of patients for 10 years or more.

Methods:

Retrospective study, with benefit and weakness assessed on a 0 to 4 subjective scale. Demographic, clinical and treatment characteristics were analyzed using t tests and Pearson correlations.

Results:

Twenty FHD patients had 10 years or longer treatment. Interinjection intervals were variable. Musicians were more likely to wait longer between injections and had less complex dystonia. There was a trend for larger benefit in women and with shorter intervals. The dose increased over time. Dystonia characteristics did not predict response or side-effects, but benefit magnitude predicted longer compliance. No serious side-effects or antibody-mediated resistance occurred.

Conclusion:

This is the longest reported period of BoNT treatment in the largest FHD cohort. BoNT therapy for FHD remains safe and effective after more than a decade of treatment. © 2011 Movement Disorder Society

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