Botulinum toxins in the treatment of primary focal dystonias

Journal of the Neurological Sciences
Daniel Truong

Abstract

Focal dystonia, such as cervical dystonia, blepharospasm, oromandibular dystonia, laryngeal dystonia, and limb dystonia, is often observed in adult-onset primary dystonia syndromes that affect a specific area of the body and tend to have little or no spread. This review will examine the past, present, and future approaches to the treatment of focal dystonia. Botulinum toxin (BoNT) has emerged as the treatment of choice for the majority of focal dystonias. Currently four products are widely available commercially, three of BoNT/A type and one of BoNT/B type. Each has important pharmacological differences that give rise to markedly different dosing recommendations. The four approved BoNTs are safe and effective for treating focal dystonias, including long-term treatment. Adverse events are limited and transient and, for the most part, mild in severity. Potential problems with the use of BoNT agents are diffusion and neutralizing antibody formation; the latter can lead to treatment resistance. Because each BoNT product is developed from distinct purification and manufacturing procedures and has varying toxin complex size and structures, physicians need to be aware of these differences when choosing an agent.

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Citations

Mar 14, 2013·Toxins·Antigone S PapavasiliouConstantine Filiopoulos
Oct 16, 2014·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Christian PedemonteDiego Lazo
May 1, 2013·Progress in Neurobiology·Christiane WoopenLars Timmermann
Apr 17, 2015·Journal of Neurology·Alberto AlbaneseCharalampos Tzoulis
Jul 1, 2015·Neurology. Clinical Practice·Brian D Berman, H A Jinnah
Nov 20, 2014·Current Neurology and Neuroscience Reports·Reversa MillsFernando Pagan

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