The EBD test--a clinical test for the detection of antibodies to botulinum toxin type A

Movement Disorders : Official Journal of the Movement Disorder Society
K R Kessler, R Benecke

Abstract

Approximately 5 to 10% of patients with cervical, segmental or multifocal dystonia receiving repetitive local injections with botulinum toxin A (BTX A) are estimated to develop secondary loss of treatment benefit (nonresponding) because of the formation of circulating serum antibodies against the neurotoxin. Because other reasons may account for loss of benefit during the course of treatment, the group of secondary nonresponders because of antibody formation need to be separated from the antibody-negative group by appropriate testing. We present an easy clinical antibody test based on a test injection of BTX A into an indicator muscle, the extensor digitorum brevis (EDB), combined with amplitude measurements of compound muscle action potentials (CMAPs) elicited by electrical nerve stimulation of the peroneal nerve before and after the injection. The results show that in a group of clinically defined secondary nonresponders, who were serologically proven to be antibody negative, a marked decrease in CMAP amplitude can consistently be detected in the injected EDB 4 weeks after BTX A injection. In contrast, antibody-positive patients are characterized by a lack of such decrease in amplitude. In all cases, results of the EDB test w...Continue Reading

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Citations

Jan 14, 2000·Movement Disorders : Official Journal of the Movement Disorder Society·F Birklein, F Erbguth
Dec 5, 2000·Movement Disorders : Official Journal of the Movement Disorder Society·D DresslerH Bigalke
Feb 24, 2001·Movement Disorders : Official Journal of the Movement Disorder Society·R R SloopM C Patel
Jul 12, 2002·Annals of Neurology·Frank BirkleinFrank Erbguth
Aug 1, 1998·Movement Disorders : Official Journal of the Movement Disorder Society·P KrackW Poewe
Nov 27, 2002·Muscle & Nerve·Paul H GordonPaul E Greene
Apr 9, 2009·Journal of Neural Transmission·Kerstin MüllerReiner Benecke
Sep 26, 2012·Journal of Neural Transmission·Markus NaumannConor J Gallagher
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