Use of botulinum toxin type F injections to treat torticollis in patients with immunity to botulinum toxin type A

Authors

  • Dr. Paul E. Greene,

    Corresponding author
    1. Dystonia Clinical Research Center, Neurological Institute, Columbia-Presyterian Medical Center, 710 West 168th Street, New York, New York, U.S.A.
    • 710 West 168th Street, New York, NY 10032, U.S.A
    Search for more papers by this author
  • Stanley Fahn

    1. Dystonia Clinical Research Center, Neurological Institute, Columbia-Presyterian Medical Center, 710 West 168th Street, New York, New York, U.S.A.
    Search for more papers by this author

Abstract

Fifteen patients with torticollis who had been treated with repeated injections of botulinum toxin type A (botox A) developed antibodies to the toxin. This resulted in loss of benefit in the 13 patients who had improved with botox A injections and failure to develop muscle atrophy after injection in all 15 patients. Patients were then injected with botulinum toxin type F (botox F) in the same muscles that had been injected with botox A. Ten of the 15 improved after botox F injections, including 9 of the 12 patients who had improved with type A toxin. Six of 9 patients with pain had improvement in pain after botox F injections. Patients reported similar improvement with type F and type A toxins, but duration of benefit was ˜3 months with type A and ˜1 month with type F. Botox F is an effective treatment for torticollis in patients who are immune to botox A. The usefulness of type F toxin, however, is limited by short duration of benefit.

Ancillary