Treatment of proximal upper limb tremor with botulinum toxin therapy

Authors

  • Samuel D. Kim MB, BS,

    1. Movement Disorders Unit, Department of Neurology, Westmead Hospital, Sydney, New South Wales, Australia
    Search for more papers by this author
  • Con Yiannikas MB, BS,

    1. Department of Neurology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
    Search for more papers by this author
  • Neil Mahant PhD,

    1. Movement Disorders Unit, Department of Neurology, Westmead Hospital, Sydney, New South Wales, Australia
    Search for more papers by this author
  • Steve Vucic PhD,

    1. Neuroscience Research Australia, Sydney, New South Wales, Australia
    2. Sydney Medical School-Western, The University of Sydney, Sydney, New South Wales, Australia
    Search for more papers by this author
  • Victor S.C. Fung PhD

    Corresponding author
    1. Movement Disorders Unit, Department of Neurology, Westmead Hospital, Sydney, New South Wales, Australia
    2. Sydney Medical School-Western, The University of Sydney, Sydney, New South Wales, Australia
    • Correspondence to: Dr. Victor S.C. Fung, Movement Disorders Unit, Department of Neurology, Westmead Hospital, Westmead, NSW, 2145 Australia; vscfung@ozemail.com.au

    Search for more papers by this author

  • Funding agencies: This study was supported by a Movement Disorder Society of Australia/Novartis Movement Disorder Scholarship.Relevant conflicts of interest/financial disclosures: Nothing to report.Full financial disclosures and author roles may be found in the online version of this article.

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. © International Parkinson and Movement Disorder Society © 2013 International Parkinson and Movement Disorder Society

Ancillary