Long-term treatment of cervical dystonia with botulinum toxin A: efficacy, safety, and antibody frequency |
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Authors: | Kirn R Kessler Michael Skutta R Benecke |
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Institution: | Neurologische Klinik und Poliklinik, Heinrich-Heine-Universit?t, Moorenstrasse 5, D-40225 Düsseldorf, Germany, DE Neurologische Klinik und Poliklinik, Universit?t Rostock, Gehlsheimer Strasse 20, D-18147 Rostock, Germany Tel.: +49-381-4949511, DE
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Abstract: | Data from 616 patients suffering from idiopathic cervical dystonia were analyzed to determine the efficacy and safety of
treatment with botulinum neurotoxin type A (BoNT/A). Since the specific purpose of this study was to determine the long-term
effects of this treatment, the analysis focused specifically on the patients (n = 303) having received six or more injections. Statistical analysis of a standardized documentation showed sustained significant
benefit as measured by a disease severity score independent of the type of cervical dystonia. Furthermore, pronounced individual
differences were found in response to this treatment although initial clinical scores and doses of BoNT/A were similar. There
was no indication of previously unknown adverse events, the only risk being the development of serum antibodies against the
toxin. As in previous studies on short-term effects of BoNT/A treatment, the most frequent adverse event was dysphagia, which
occurred on average 9.7 days after injection and lasted on average 3.5 weeks. While secondary nonresponse was seen in approx.
5% of patients, antibody tests revealed neutralizing serum antibodies in only 2%. On the basis of the present data, therapy
of cervical dystonia with BoNT/A seems to be safe and yields good stable results even after 5 years of treatment.
Received: 26 June 1997 Received in revised form: 17 July 1998 Accepted: 4 August 1998 |
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Keywords: | Cervical dystonia Torticollis Botulinum toxin Prospective follow-up study Antibodies |
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