Journal of Neurology

, Volume 246, Issue 4, pp 265–274

Long-term treatment of cervical dystonia with botulinum toxin A: efficacy, safety, and antibody frequency

  • Kirn R. Kessler
  • Michael Skutta
  • R. Benecke
  • for the German Dystonia Study Group
Original communication

DOI: 10.1007/s004150050345

Cite this article as:
Kessler, K., Skutta, M., Benecke, R. et al. J Neurol (1999) 246: 265. doi:10.1007/s004150050345

Abstract

Data from 616 patients suffering from idiopathic cervical dystonia were analyzed to determine the efficacy and safety of treatment with botulinum neurotoxin type A (BoNT/A). Since the specific purpose of this study was to determine the long-term effects of this treatment, the analysis focused specifically on the patients (n = 303) having received six or more injections. Statistical analysis of a standardized documentation showed sustained significant benefit as measured by a disease severity score independent of the type of cervical dystonia. Furthermore, pronounced individual differences were found in response to this treatment although initial clinical scores and doses of BoNT/A were similar. There was no indication of previously unknown adverse events, the only risk being the development of serum antibodies against the toxin. As in previous studies on short-term effects of BoNT/A treatment, the most frequent adverse event was dysphagia, which occurred on average 9.7 days after injection and lasted on average 3.5 weeks. While secondary nonresponse was seen in approx. 5% of patients, antibody tests revealed neutralizing serum antibodies in only 2%. On the basis of the present data, therapy of cervical dystonia with BoNT/A seems to be safe and yields good stable results even after 5 years of treatment.

Key words Cervical dystonia Torticollis Botulinum toxin Prospective follow-up study Antibodies 

Copyright information

© Steinkopff Verlag 1999

Authors and Affiliations

  • Kirn R. Kessler
    • 1
  • Michael Skutta
    • 1
  • R. Benecke
    • 2
  • for the German Dystonia Study Group
  1. 1.Neurologische Klinik und Poliklinik, Heinrich-Heine-Universität, Moorenstrasse 5, D-40225 Düsseldorf, GermanyDE
  2. 2.Neurologische Klinik und Poliklinik, Universität Rostock, Gehlsheimer Strasse 20, D-18147 Rostock, Germany Tel.: +49-381-4949511DE