Prognostic factors of long-standing improvement in cervical dystonia, treated with botulinum a toxin
Sławek, J.ła.; Cielecka, A.; Duzyński, W.
Neurologia i Neurochirurgia Polska 36(1): 47-56
2002
ISSN/ISBN: 0028-3843 PMID: 12053615 Document Number: 550487
The clinical improvement after injections of botulinum toxin A in patients with idiopathic spasmodic torticollis lasts usually about 3 months. Nevertheless in some patients it exceeds several months. The aim of our study was to assess the frequency of prolonged response (arbitrally established as > 6 months) and to find the possible prognostic factors of such longer effect. In the group of 43 patients (F30, M13), average age 43.9 (19-72) years, we observed prolonged effect in 13 (30.2%). In 5 of them remission was repeated in following sessions (two times in four and four times in one). The frequency of spontaneous remissions in spasmodic torticollis (12%) is significantly lower than after botulinum toxin, what means that they are triggered by drug injection in our group of patients with prolonged effect. Within the analysed parameters only the lower average age and the average age at the onset of symptoms statistically significantly differ in both groups. The authors suggest the possibility of other mechanisms responsible for prolonged clinical effect after botulinum toxin: e.g. different time of reinnervation (remodelling of synapses) or the modification of natural course (feed-back mechanisms) of spasmodic torticollis in some patients.