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Botulinum Toxin Type A Application Experiences in Bolu Abant İzzet Baysal University Neurology Clinic

Year 2022, Volume: 12 Issue: 3, 401 - 406, 20.09.2022
https://doi.org/10.33631/sabd.1052875

Abstract

Aim: The aim of this study was to evaluate the effects of different clinical applications of BoNT-A as hemifacial spasm, blepharospasm, cervical dystonia, bruxism, head tremor and spasticity in stroke, Multiple Sclerosis (MS), spinal trauma, hereditary spastic paraplegia, cerebral palsy, and chronic migraine.
Material and Methods: In this retrospective study, which was conducted between January 2019 and December 2021, 79 patients with movement disorders, spasticity, and chronic migraine monitored in our clinic and whose BoNT-A injections were applied were included. The diagnosis and treatment, side effects encountered in therapy, follow-up during the treatment, and the response to the treatment evaluated subjectively by patients were discussed.
Results: The improvement in patients' response to treatment was subjectively reported by themselves. The improvement in the response of the patients to the treatment subjectively stated that improvement of 60% and above was taken as good, improvement between 59-40% moderate, and improvement of 39% and below bad. Accordingly, 78.94% of the patients subjectively stated improvement as good, 13.15% as moderate, and 7.89% as bad. Although the incidence of complications was 9.21%, these side effects were mild and transient in all of the patients and did not cause any of the patients to discontinue the treatment.
Conclusion: The results were statistically significant and consistent with the literature. This study supports the fact that botulinum toxin therapy is effective and safe for HS, BS, cervical dystonia, spasticity, bruxism, head tremor, and chronic migraine.

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Project Number

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References

  • REFERENCES Simpson LL. The origin, structure, and pharmacological activity of botulinum toxin. Pharmacol Rev. 1981; 33: 155-88.
  • Jankovic J, Albanese A, Atassi MZ, Dolly JO, Hallet M, Mayer N. Botulinum toxin E-Book: Therapeutic clinical practice and science. Elsevier Health Sciences. 2008.
  • Akdemir MO, Uğurbaş SC, Uğurbaş SH. Benign esansiyel blefarospazm ve hemifasiyal spazm tedavisinde botulinum toksin uygulamasının uzun dönem etkisi. Turk J Ophthalmol. 2015; 45(1): 9-13.
  • Evidente VGH, Adler CH. Hemifacial spasm and other craniofacial movement disorders. Mayo Clin Proc. 1998; 73(1): 67-71.
  • Ramirez-Castaneda J, Jankovic J. Long-term efficacy and safety of botulinum toxin injections in dystonia. Toxins. 2013; 5(2): 249-66.
  • Mittal S, Machado D. Botulinum toxin in parkinson disease tremor: A randomized, double-blind, placebo-controlled study with a customized ınjection approach. Mayo Clin Proc. 2017; 92(9): 1359-67.
  • Siddiqui M, Shah PV, Balani P, Lopez A R, Nobleza CMN, Khan S. Comparing the efficacy, safety, and superiority of calcitonin gene-related peptide monoclonal antibodies and botox in preventing and treating migraines. Cureus, 2021; 13(1): e13002.
  • Burç H, Atay T, Baykal YB, Baydar M L, Kırdemir V. Serebral palside botulinum toksininin yeri. Medical Journal of Suleyman Demirel University. 2011; 18(2): 78-81.
  • Trosch RM. Pullman SL. Botilinum toxin A injections for the treatment of hand tremors. Movement disorders: official journal of the Movement Disorder Society. 1994; 9(6): 601-9.
  • Shuhendler AJ, Lee S, Siu MM, Ondovcik M S, Lam MK, Alabdullatif MA et al. Efficacy of botulinum toxin type A for the prophylaxis of episodic migraine headaches: a meta-analysis of randomized, double-blind, placebo-controlled trials. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2009; 29(7): 784-91.
  • Altun Y. Botulinum toxin application experiences in Adıyaman University, Department of Neurology: A retrospective study. Kafkas J Med Sci. 2017; 7(2): 134-8.
  • Cakmur R. Blefarospazm ve hemifasiyal spazmda botulinum toksini tedavisi/botulinum toxin treatment of blepharospasm and hemifacial spasm. Noro-Psikyatri Arsivi. 2010; 47: 6-10.
  • Green P, Fahn S, Diamond B. Development of resistance to botulinum toxin type A in patients with torticollis. Mov Disord. 1994; 9(2): 213-7.
  • Grazko MA, Polo KB, Jabbari B. Botulinum toxin A for spasticity, muscle spasms, and rigidity. Neurology. 1995; 45(4): 712-7.
  • Ünlü E, Cevikol A, Bal B, Gonen E, Celik O, Kose G. Multilevel botulinum toxin type A as a treatment for spasticity in children with cerebral palsy: A retrospective study. Clinics. 2010; 65(6): 613-9.
  • Karaca B, Ünlü E, Köse G, Gönen E. Çakcı A. Outcomes of botulinum toxin type A injection followed by rehabilitation in cases of cerebral palsy with upper extremity involvement. Journal of Child. Neurology. 2016; 31(3): 357-63.
  • Simpson DM. Clinical trials of botulinum toxin in the treatment of spasticity. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 1997; 20(S6): 169-75.
  • Karp BI. Treatment of limb dystonia with Botilinum Toxin. American Academy of Neurology. 2001; Syllabi-on-CD-Rom, Clinical Usefulness of Botilinum Toxin and Treatment of Dystonia. 2SW.001.
  • Comella CL, Brin M, Jankovic J. Botulinum toxin in the clinical management of cervical dystonia. Neurology. 2000; 55(S5): 1-35.
  • Hsiung GY, Das SK, Ranawaya R, Lafontaine AL, Suchowersky O. Long‐term efficacy of botulinum toxin A in treatment of various movement disorders over a 10‐year period. Movement disorders: official journal of the Movement Disorder Society. 2002; 17(6): 1288-93.
  • Snir M, Weinberger D, Bourla D, Kristal-Shalit O, Dotan G, Axer-Siegel R. Quantitative changes in botulinum toxin a treatment over time in patients with essential blepharospasm and idiopathic hemifacial spasm. American journal of ophthalmology. 2003; 136(1): 99-105.
  • Ababneh OH, Cetinkaya A, Kulwin DR. Long‐term efficacy and safety of botulinum toxin A injections to treat blepharospasm and hemifacial spasm. Clinical & experimental ophthalmology. 2014; 42(3): 254-61.
  • Jankovic J. Schwartz K. Botulinum toxin treatment of tremors. Neurology. 1991; 41(8): 1185-1185.
  • Anderson TJ, Rivest J, Stell R, Steiger MJ, Cohen H, Thompson PD, et al. Botulinum toxin treatment of spasmodic torticollis. Journal of the royal society of medicine. 1992; 85(9): 524-9
  • Tüfekçi A. Botulinum toksini uygulamalarında olası yan etkiler ve takipleri. Turkiye Klinikleri J Neurol-Special Topics. 2013; 6(4): 46-51.
  • Matur Z, Parman YG. Spastisite tedavisinde a tipi botulinum toksini kullanimi/Use of botulinum toxin type a in the treatment of spasticity. Noro-Psikyatri Arsivi. 2010; 47: 40-3.
  • Naumann M, Boo LM, Ackerman AH, Gallagher CJ. Immunogenicity of botulinum toxins. Journal of neural transmission. 2013; 120(2): 275-90.
  • Nüβgens Z, Roggenkämper P. Comparison of two botulinum-toxin preparations in the treatment of essential blepharospasm. Graefe's archive for clinical and experimental ophthalmology. 1997; 235(4): 197-9.
  • Sorgun MH, Yilmaz R, Akin YA, Mercan FN, Akbostanci MC. Botulinum toxin injections for the treatment of hemifacial spasm over 16 years. Journal of Clinical Neuroscience. 2015; 22(8): 1319-25.
  • Costa J, Espírito‐Santo CC, Borges AA, Ferreira J, Coelho MM, Moore P, et al. Botulinum toxin type A therapy for blepharospasm. Cochrane Database of Systematic Reviews. 2004; 2.
  • Duarte GS, Rodrigues FB, Marques RE, Castelao M, Ferreira J, Sampaio C, et al. Botulinum toxin type A therapy for blepharospasm. Cochrane Database of Systematic Reviews. 2020; 11.
  • Bhidayasiri R, Cardoso F, Truong DD. Botulinum toxin in blepharospasm and oromandibular dystonia: comparing different botulinum toxin preparations. European Journal of Neurology. 2006; 13: 21-9.
  • Anandan C, Jankovic J. Botulinum toxin in movement disorders: An update. Toxins. 2021; 13(1): 42.

Bolu Abant İzzet Baysal Üniversitesi Nöroloji Kliniğinde Botulinum Toksin Uygulamaları Deneyimleri

Year 2022, Volume: 12 Issue: 3, 401 - 406, 20.09.2022
https://doi.org/10.33631/sabd.1052875

Abstract

Amaç: Bu çalışmanın amacı, nöroloji klinik uygulamalarında uzun zamandır önemli yer tutan Botulinum Nörotoksin tip A(BoNT-A)'nın hemifasiyal spazm(HS), blefarospazm(BS), servikal distoni, bruksizm, baş tremoru gibi hareket hastalıklarıyla; inme, multiple skleroz(MS), spinal travma, herediter spastik parapleji(HSP) ve serebral palsi gibi farklı spastisite çeşitlerinde ve kronik migrende, uygulamalarının klinikteki etkilerini değerlendirmektir.
Gereç ve Yöntemler: Bu retrospektif çalışmada, Ocak 2019 – Aralık 2021 tarihleri arasında kliniğimizde izlenen, aynı nörolog tarafından BoNT-A tedavileri uygulanan ve takip edilen;HS, BS, spastisite, servikal distoni, bruksizm,baş tremoru ve oral medikal tedaviye dirençli kronik migrenli, yaşları 21-85 arası 79 hastanın tanı ve tedavisi, tedavi doz ve uygulama şekilleri ile BoNT-A'ya verilen yanıtlar, tedavide sık görülen yan etkiler, tedavi süresince yapılan hasta takipleri ve hastalar tarafından subjektif olarak değerlendirilen tedaviye yanıtları, betimleyici istatistikler kullanılarak raporlanmış ve literatür eşliğinde tartışılmıştır.
Bulgular: Hastaların, tedaviye yanıtlarındaki düzelme ilaç enjeksiyonundan yaklaşık bir ay sonra kontrol muayeneye geldiklerinde belirttikleri şekilde değerlendirildi. Hastalar, subjektif olarak %60 ve üzeri düzelmeyi iyi, %59-40 arası düzelmeyi orta, %39 ve altı düzelmeyi kötü olarak ifade etti. Buna göre hastaların %78,94'ü subjektif olarak iyileşmeyi iyi, % 13,15'i orta ve % 7,89 i kötü olarak belirtti. Komplikasyon insidansı % 9,21 olmasına rağmen bu yan etkiler tüm hastalarda hafif ve geçici olup hiçbir hastanın tedaviyi bırakmasına neden olmadı.
Sonuç: Sonuçlar literatürle uyumlu olarak anlamlıydı. Bu çalışma, BoNT-A tedavisinin HS, BS, Servikal distoni, inme sonrası spastisite, serebral palsi, bruksizm, baş tremoru ve kronik migren için etkili ve güvenli bir tedavi olduğu gerçeğini desteklemektedir.

Project Number

-

References

  • REFERENCES Simpson LL. The origin, structure, and pharmacological activity of botulinum toxin. Pharmacol Rev. 1981; 33: 155-88.
  • Jankovic J, Albanese A, Atassi MZ, Dolly JO, Hallet M, Mayer N. Botulinum toxin E-Book: Therapeutic clinical practice and science. Elsevier Health Sciences. 2008.
  • Akdemir MO, Uğurbaş SC, Uğurbaş SH. Benign esansiyel blefarospazm ve hemifasiyal spazm tedavisinde botulinum toksin uygulamasının uzun dönem etkisi. Turk J Ophthalmol. 2015; 45(1): 9-13.
  • Evidente VGH, Adler CH. Hemifacial spasm and other craniofacial movement disorders. Mayo Clin Proc. 1998; 73(1): 67-71.
  • Ramirez-Castaneda J, Jankovic J. Long-term efficacy and safety of botulinum toxin injections in dystonia. Toxins. 2013; 5(2): 249-66.
  • Mittal S, Machado D. Botulinum toxin in parkinson disease tremor: A randomized, double-blind, placebo-controlled study with a customized ınjection approach. Mayo Clin Proc. 2017; 92(9): 1359-67.
  • Siddiqui M, Shah PV, Balani P, Lopez A R, Nobleza CMN, Khan S. Comparing the efficacy, safety, and superiority of calcitonin gene-related peptide monoclonal antibodies and botox in preventing and treating migraines. Cureus, 2021; 13(1): e13002.
  • Burç H, Atay T, Baykal YB, Baydar M L, Kırdemir V. Serebral palside botulinum toksininin yeri. Medical Journal of Suleyman Demirel University. 2011; 18(2): 78-81.
  • Trosch RM. Pullman SL. Botilinum toxin A injections for the treatment of hand tremors. Movement disorders: official journal of the Movement Disorder Society. 1994; 9(6): 601-9.
  • Shuhendler AJ, Lee S, Siu MM, Ondovcik M S, Lam MK, Alabdullatif MA et al. Efficacy of botulinum toxin type A for the prophylaxis of episodic migraine headaches: a meta-analysis of randomized, double-blind, placebo-controlled trials. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2009; 29(7): 784-91.
  • Altun Y. Botulinum toxin application experiences in Adıyaman University, Department of Neurology: A retrospective study. Kafkas J Med Sci. 2017; 7(2): 134-8.
  • Cakmur R. Blefarospazm ve hemifasiyal spazmda botulinum toksini tedavisi/botulinum toxin treatment of blepharospasm and hemifacial spasm. Noro-Psikyatri Arsivi. 2010; 47: 6-10.
  • Green P, Fahn S, Diamond B. Development of resistance to botulinum toxin type A in patients with torticollis. Mov Disord. 1994; 9(2): 213-7.
  • Grazko MA, Polo KB, Jabbari B. Botulinum toxin A for spasticity, muscle spasms, and rigidity. Neurology. 1995; 45(4): 712-7.
  • Ünlü E, Cevikol A, Bal B, Gonen E, Celik O, Kose G. Multilevel botulinum toxin type A as a treatment for spasticity in children with cerebral palsy: A retrospective study. Clinics. 2010; 65(6): 613-9.
  • Karaca B, Ünlü E, Köse G, Gönen E. Çakcı A. Outcomes of botulinum toxin type A injection followed by rehabilitation in cases of cerebral palsy with upper extremity involvement. Journal of Child. Neurology. 2016; 31(3): 357-63.
  • Simpson DM. Clinical trials of botulinum toxin in the treatment of spasticity. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 1997; 20(S6): 169-75.
  • Karp BI. Treatment of limb dystonia with Botilinum Toxin. American Academy of Neurology. 2001; Syllabi-on-CD-Rom, Clinical Usefulness of Botilinum Toxin and Treatment of Dystonia. 2SW.001.
  • Comella CL, Brin M, Jankovic J. Botulinum toxin in the clinical management of cervical dystonia. Neurology. 2000; 55(S5): 1-35.
  • Hsiung GY, Das SK, Ranawaya R, Lafontaine AL, Suchowersky O. Long‐term efficacy of botulinum toxin A in treatment of various movement disorders over a 10‐year period. Movement disorders: official journal of the Movement Disorder Society. 2002; 17(6): 1288-93.
  • Snir M, Weinberger D, Bourla D, Kristal-Shalit O, Dotan G, Axer-Siegel R. Quantitative changes in botulinum toxin a treatment over time in patients with essential blepharospasm and idiopathic hemifacial spasm. American journal of ophthalmology. 2003; 136(1): 99-105.
  • Ababneh OH, Cetinkaya A, Kulwin DR. Long‐term efficacy and safety of botulinum toxin A injections to treat blepharospasm and hemifacial spasm. Clinical & experimental ophthalmology. 2014; 42(3): 254-61.
  • Jankovic J. Schwartz K. Botulinum toxin treatment of tremors. Neurology. 1991; 41(8): 1185-1185.
  • Anderson TJ, Rivest J, Stell R, Steiger MJ, Cohen H, Thompson PD, et al. Botulinum toxin treatment of spasmodic torticollis. Journal of the royal society of medicine. 1992; 85(9): 524-9
  • Tüfekçi A. Botulinum toksini uygulamalarında olası yan etkiler ve takipleri. Turkiye Klinikleri J Neurol-Special Topics. 2013; 6(4): 46-51.
  • Matur Z, Parman YG. Spastisite tedavisinde a tipi botulinum toksini kullanimi/Use of botulinum toxin type a in the treatment of spasticity. Noro-Psikyatri Arsivi. 2010; 47: 40-3.
  • Naumann M, Boo LM, Ackerman AH, Gallagher CJ. Immunogenicity of botulinum toxins. Journal of neural transmission. 2013; 120(2): 275-90.
  • Nüβgens Z, Roggenkämper P. Comparison of two botulinum-toxin preparations in the treatment of essential blepharospasm. Graefe's archive for clinical and experimental ophthalmology. 1997; 235(4): 197-9.
  • Sorgun MH, Yilmaz R, Akin YA, Mercan FN, Akbostanci MC. Botulinum toxin injections for the treatment of hemifacial spasm over 16 years. Journal of Clinical Neuroscience. 2015; 22(8): 1319-25.
  • Costa J, Espírito‐Santo CC, Borges AA, Ferreira J, Coelho MM, Moore P, et al. Botulinum toxin type A therapy for blepharospasm. Cochrane Database of Systematic Reviews. 2004; 2.
  • Duarte GS, Rodrigues FB, Marques RE, Castelao M, Ferreira J, Sampaio C, et al. Botulinum toxin type A therapy for blepharospasm. Cochrane Database of Systematic Reviews. 2020; 11.
  • Bhidayasiri R, Cardoso F, Truong DD. Botulinum toxin in blepharospasm and oromandibular dystonia: comparing different botulinum toxin preparations. European Journal of Neurology. 2006; 13: 21-9.
  • Anandan C, Jankovic J. Botulinum toxin in movement disorders: An update. Toxins. 2021; 13(1): 42.
There are 33 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Canan Akünal Türel

Project Number -
Publication Date September 20, 2022
Submission Date January 3, 2022
Published in Issue Year 2022 Volume: 12 Issue: 3

Cite

Vancouver Akünal Türel C. Botulinum Toxin Type A Application Experiences in Bolu Abant İzzet Baysal University Neurology Clinic. VHS. 2022;12(3):401-6.