Retrospective Evaluation of 118 Cervical Dystonic Cases Treated with Botulinum Toxin

Abstract

OBJECTIVE: In this article the aim is to investigate the efficacy and adverse effects of Botulinum toxin. Botox and Dysport were compared when appropriate.

METHODS: This is a retrospective study. Between July 1996- July 2006; 470 sessions of botulinum toxin injection were applied to 118 patients with cervical dystonia. The initial time of improvement, duration and degree of improvement, frequency and duration of adverse effects, and when appropriate differences between Botox and Dyport were analysed.

RESULTS: An average value of 153.4 units (Botox equivalent dose) were used. The patients felt the first improvement after 8.7 days and they returned to their conditions before injection after 2.9 months. Patients expressed 57.5% improvement on average in a visual analog scale. In 72.3% of injections no adverse effect was observed, in 8.3% dysphagia, in 7.7% pain in neck, in 5.1% weakness in the neck, and neck drop, in %3.2 changing of the dystonia type, in 2.2% dry mounth were detected. Aphonia, prickling in the neck, vertigo, itching, ptosis, fatigue, stuffiness, atrophy in neck muscles, syncope during injection was detected as 1,2%. When commercial preperations compared; average improvement was 58.7% with Botox, 44,1% with Dysport; duartion of improvement was 2.9 months with Botox, 2,3 months with Dysport; and frequency of adverse effects was 25.3% with Botox and was%62.5 with Dysport.

CONCLUSION: Although results of the previously reported controlled studies are highly variable, our results are within the reported limits. Botox and Dyport were frequently reported to be equivalent when correct dilution ratios were used. To our opinion, the reason Botox is calculated to be more effective and with less frequent adverse effects, in this study, is that we had less than enough experience with Dysport and used the incorrect dilution ratio of 1/5 at the time when study is performed.