Skip to main content
SpringerLink
Log in

Botulinum toxin treatment in patients with focal dystonia and hemifacial spasm. A multicenter study of the Italian Movement Disorder Group

  • Original Articles
  • Published:
The Italian Journal of Neurological Sciences Aims and scope Submit manuscript

Abstract

In six Centers belonging to the Italian Movement Disorder Study Group, the efficacy of botulinum toxin treatment was evaluated in an open collaborative study in 251 patients with focal dystonia and hemifacial spasm. The percentage of functional improvement ranged from 66% to 81% in patients with blepharospasm, from 40% to 51% in patients with spasmodic torticollis and from 73% to 81% in those with hemifacial spasm. Good results were also obtained in patients with oromandibular dystonia, laryngeal dystonia and writer's cramp. Side effects were mild and transient. Local botulinum toxin injection is the first choice symptomatic treatment in focal dystonia and hemifacial spasm.

Sommario

In 6 centri facenti parte del Gruppo Italiano per lo Studio dei Disturbi del Movimento è stata valutata l'efficacia della somministrazione di tossina botulinica A in 251 pazienti affetti da distonia focale e da spasmo del facciale.

Nei pazienti con blefarospasmo, la percentuale media di miglioramento osservata è compresa tra il 66 e l'81%, mentre nei pazienti con torcicollo varia tra il 40% e il 51%. Nei pazienti affetti da spasmo del facciale la percentuale media di miglioramento è compresa tra il 73% e l'81%. Buoni risultati sono stati ottenuti anche nella terapia di distonie focali meno frequenti, come la distonia oromandibolare e laringea e il crampo dello scrivano. Gli effetti collaterali osservati sono risultati generalmente lievi, locali e transitori.

Lo studio conferma quindi l'utilità della tossina botulinica nella terapia sintomatica delle distonie focali e nello spasmo del facciale.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alexander G.E., Moses H.:Carbamazepine for hemifacial spasm. Neurology 32:286–287, 1982.

    CAS  PubMed  Google Scholar 

  2. Berardelli A., Carta A., Stocchi F. et al.:Botulinum A toxin injection in patients with blepharospasm, torticollis and hemifacial spasm. Ital. J. Neurol. Sci. 11:589–593, 1990.

    Article  CAS  PubMed  Google Scholar 

  3. Bertrand C.M., Molina-Negro P.:Selective peripheral nerve denervation in 111 cases of spasmodic torticollis. Adv. Neurol. 50:637–643, 1988.

    CAS  PubMed  Google Scholar 

  4. Brin M.F., Fahn S., Moskowitz C. et al.:Localized injection of botulinum toxin for the treatment of focal dystonia and hemifacial spasm. Mov. Disord. 4:237–254, 1987.

    Google Scholar 

  5. Dutton J., Backley E.:Botulinum toxin in the management of blepharospasm. Arch. Neurol. 43:380–382, 1986.

    CAS  PubMed  Google Scholar 

  6. Elston J.S., Russell R.W.R.:Effects of treatment with botulinum toxin on neurogenic blepharospasm. Br. Med. J. 290:1857–1958, 1985.

    CAS  Google Scholar 

  7. Elston J.S.:Botulinum toxin A in clinical medicine. J. Physiol. (Paris) 84:285–289, 1990.

    CAS  Google Scholar 

  8. Fahn S.:Treatment of dystonia with high dosage anticholinergic medications. Neurology 29:605, 1979.

    Google Scholar 

  9. Fahn S., Marsden C.D., Calne D.B.:Classification and investigation of dystonia. In: Marsden C.D. and Fahn S. eds., Movement Disorder, London Butterworth 333–358, 1987.

    Google Scholar 

  10. Gelb D.J., Lowenstein D.H., Aminoff M.J.:Controlled trial of botulinum toxin injections in the treatment of spasmodic torticollis. Neurology 39:80–84, 1989.

    CAS  PubMed  Google Scholar 

  11. Grandas F., Elston J., Quinn N., Marsden C.D.:Blepharospasm: a review of 264 patients. J. Neurol. Neurosurg. Psychiatry 51:616–623, 1988.

    Google Scholar 

  12. Herzberg L.:Management of hemifacial spasm with clonazepam. Neurology 35:1676–1677, 1985.

    CAS  PubMed  Google Scholar 

  13. Jankovic J., Orman J.:Botulinum A toxin for cranial cervical dystonia: a double-blind placebocontrolled study. Neurology 37:616–623, 1987.

    CAS  PubMed  Google Scholar 

  14. Jankovic J., Fahn S.:Dystonic syndromes. In: Jankovic J., Tolosa E., eds. “Parkinson's disease and movement disorders”, Baltimore, MD: Urban and Schwarzenberg, 283–314, 1988.

    Google Scholar 

  15. Jankovic J., Brin M.F.:Therapeutic uses of botulinum toxin. N. Eng. J. Med. 324:1186–1194, 1991.

    CAS  Google Scholar 

  16. Kao I., Drachman D.B., Price B.L.:Botulinum toxin mechanism of presynaptic blockade. Science 193:1256–1258, 1976.

    CAS  PubMed  Google Scholar 

  17. Maccabee J.J.:Surgical treatment of spasmodic torticollis. In: Marsden C.D. and Fahn S., Eds. Movement Disorders, London, Butterworths Int. Med. Rev. 308–314, 1982.

    Google Scholar 

  18. Marsden C.D., Schachter M.:Assessment of extrapyramidal disorders. Br. J. Clin. Pharmacol. 11:129–151, 1981.

    CAS  PubMed  Google Scholar 

  19. Mauriello J.A.:Blepharospams, Meige's syndrome and hemifacial spasm: treatment with botulinum toxin. Neurology 35:1499–1500, 1985.

    PubMed  Google Scholar 

  20. Nielsen V.K., Jannetta P.J.:Effects of facial nerve decompression. Neurology 34:891–897, 1984.

    CAS  PubMed  Google Scholar 

  21. Quinn N., Hallett M.:Dose standardisation of botulinum toxin. Lancet, 1:964, 1989.

    CAS  PubMed  Google Scholar 

  22. Scott A.B.:Botulinum toxin injection of eye muscles to correct strabismus. Trans. Am. Ophthalmol. Soc. 79:734–770, 1981.

    CAS  PubMed  Google Scholar 

  23. Scott A.B., Kennedy R.A., Stubbs H.A.:Botulinum A toxin injection as a treatment for blepharospasm. Arch. Ophthalmol. 103:718–719, 1985.

    Google Scholar 

  24. Tsui J.K.C., Eisen A., Stoessl A.J. et al.:Double-blind study of botulinum toxin in spasmodic torticollis. Lancet 2:245–247, 1986.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Scienze Neurologiche, Università “La Sapienza”, Viale Università 30, 00185, Roma

    Berardelli A., Formica A., Mercuri B., Agnoli A., Agostino R., Priori A., Stocchi F. & Manfredi M.

  2. Clinica Malattie Nervose e Mentali, Università di Bari, Bari, Italia

    Fazio G. De & Lepore V.

  3. Clinica Neurologica, Arcispedale S. Anna, Ferrara

    Grandis D. De, Eleopra R. & Tugnoli V.

  4. Clinica Neurologica, Università di Genova, Genova, Italia

    Abbruzzese G.

  5. Clinica Neurologica, Università di Messina, Messina, Italia

    Girlanda P., Messina C. & Milone S.

  6. Istituto Nazionale Neurologico “C. Besta”, Milano

    Caraceni T. & Carella F.

Authors
  1. Berardelli A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Formica A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mercuri B.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Abbruzzese G.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Agnoli A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Agostino R.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Caraceni T.
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Carella F.
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Fazio G. De
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Grandis D. De
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Eleopra R.
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Girlanda P.
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Lepore V.
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Messina C.
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Milone S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Priori A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Stocchi F.
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Tugnoli V.
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Manfredi M.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Berardelli, A., Formica, A., Mercuri, B. et al. Botulinum toxin treatment in patients with focal dystonia and hemifacial spasm. A multicenter study of the Italian Movement Disorder Group. Ital J Neuro Sci 14, 361–367 (1993). https://doi.org/10.1007/BF02340723

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02340723

Key Words

Search

Navigation