Movement Disorders Institute and Department of Neurology, Chaim Sheba Medical Center, Ramat-Gan, Israel.
Movement Disorders Clinic and Department of Neurology, Shaare Zedek Medical Center, Jerusalem, Israel.
Neurotox Res. 2021 Aug;39(4):1352-1359. doi: 10.1007/s12640-021-00378-2. Epub 2021 May 29.
Botulinum toxin (BT) injections into the cervical muscles are an effective and commonly practiced treatment approach for cervical dystonia. In this retrospective longitudinal study, we collected data from the Sheba electronic medical records on consecutive patients with idiopathic cervical dystonia (ICD), treated regularly with periodic BT injections between the years 2008-2020. All treatment visits were analyzed regarding type of toxin, dose injected, and clinical outcomes. The vast majority of patients were treated with abobotulinum toxin A. Sixty-four ICD patients (51 (79.7%) females, onset at age 45.8 ± 13.7 years) were treated over 17.1 ± 13.9 (range 3 to 49) visits per patient; BT treatment efficacy increased gradually from initial treatment sessions to visit 13, when it achieved a steady state. While the subjective report of percentage improvement and its duration were around 78.9 ± 17.1% for 2.8 ± 1.0 months, respectively, the dose of BT increased significantly over the years (p = 0.006). Side effects (SE) were not rare, and commonly recurred after subsequent sessions and were usually mild and short-lasting, with dysphagia being the most common (~17.5%), followed by neck/arm weakness (11.9%) and cervical pain (8.9%). Repeated injections of BT for ICD remain beneficial for patients over several years of therapy, and despite mild SE, patients tend to adhere to a 3-4 months interval schedule.
肉毒杆菌毒素（BT）注射到颈部肌肉是治疗颈肌张力障碍的一种有效且常用的方法。在这项回顾性纵向研究中，我们从谢巴电子病历中收集了 2008 年至 2020 年间连续接受特发性颈肌张力障碍（ICD）治疗且定期接受周期性 BT 注射的患者的数据。所有治疗就诊均分析了毒素类型、注射剂量和临床结果。绝大多数患者接受了阿巴毒素 A 的治疗。64 例 ICD 患者（51 名女性（79.7%），发病年龄为 45.8±13.7 岁）接受了 17.1±13.9（范围 3 至 49）次/患者的治疗；BT 治疗效果从初始治疗阶段逐渐增加到第 13 次治疗，此时达到稳定状态。尽管主观报告的改善百分比及其持续时间分别约为 78.9±17.1%和 2.8±1.0 个月，但 BT 剂量在过去几年中显著增加（p=0.006）。副作用（SE）并不罕见，并且在随后的治疗中经常复发，通常为轻度且短暂，吞咽困难最为常见（约 17.5%），其次是颈部/手臂无力（11.9%）和颈部疼痛（8.9%）。反复注射 BT 治疗 ICD 对患者在数年内仍然有益，尽管有轻度 SE，但患者倾向于坚持 3-4 个月的间隔方案。
