Abstract Details

Title Long-Term Efficacy, Safety, and Side Effect Profile of Botulinum Toxin Injections in Dystonia - A 20-Year Follow-Up

Topic Movement Disorders

Presentation(s) P07 - (-)

Poster/Presentation
Number 197

Objective

Background BACKGROUND: Botulinum toxin (BoNT) injections have emerged as one of the most effective therapeutic modalities not only in Neurology but in nearly all fields of Medicine. With the chronic use of BoNT and an expanding list of therapeutic indications there is a need to carefully examine the long-term efficacy and safety of BoNT treatment.

Design/Methods DESIGN/METHODS: Of 1,636 patients injected with BoNT at the PDCMDC, from September 1981 through December 1996, 1,361 had dystonia as a primary therapeutic indication of which 104 had continuous treatment of ? 1 injection visit per year for at least 15 years and are still being treated at our center. Detailed demographic, clinical, treatment response, and adverse events data were entered from the 'Botulinum Toxin Data Form' and medical chart into a database and analyzed.

Results RESULTS: Of 104 patients 75 were women, the mean age at first injection was 48.9 ± 12.4 years (range: 8.4 to 74.2), and women were older (51.2 ± 10.0 years) than men (43.1 ± 15.9 years) (P = 0.003). At the time of their last visit, the mean age was 68.3 ± 12.5 years (range: 25.1 to 89.8); the mean follow-up period was 19.4 ± 2.9 years (range, 15.5 to 26.5). The primary diagnoses were cervical dystonia (54.8%), cranial dystonia (25.0%), spasmodic dysphonia (11.5%), oro-mandibular dystonia (10.5%), tardive dystonia (9.6%), blepharospasm (7.7%), torsion dystonia (6.7%), focal dystonia (5.7%), and other dystonias (2.8%).

Conclusions CONCLUSIONS: In over three decades of experience with BoNT for the treatment of dystonia and other movement disorders, 104 patients received continuous BoNT treatment for 20 years with persistent benefit and minimal adverse effects, thus supporting the conclusion that BoNT is a safe and effective long-term treatment for focal and segmental dystonia.

Authors/Disclosures
Juan L. Ramirez Castaneda, MD (Methodist Physicians. Neurosurgery and Neurology Specialists) PRESENTER	Dr. Ramirez Castaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. Dr. Ramirez Castaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie . Dr. Ramirez Castaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Ramirez Castaneda has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Supernus. Dr. Ramirez Castaneda has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie .
Joseph Jankovic, MD, FAAN (Baylor College of Medicine)	Dr. Jankovic has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Revance. Dr. Jankovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Revance, Allergan. The institution of Dr. Jankovic has received research support from Baylor College of Medicine. Dr. Jankovic has received research support from Abbvie. The institution of Dr. Jankovic has received research support from Abbvie.
	No disclosure on file

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