Retrospective Evaluation of 118 Cervical Dystonic Cases Treated with Botulinum Toxin

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Akin Y. A., AKBOSTANCI M. C., Mercan F. N., Aksun Z., SORGUN M. H.

TURKISH JOURNAL OF NEUROLOGY, no.3, pp.104-107, 2012 (ESCI) identifier

  • Publication Type: Article / Article
  • Publication Date: 2012
  • Doi Number: 10.4274/tnd.76598
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Page Numbers: pp.104-107
  • Eskisehir Osmangazi University Affiliated: No


Objective: In this article the aim is to investigate the efficacy and adverse effects of Botulinum toxin. Botox and Dysport were compared when appropriate. Material and Method: This is a retrospective study. Between July 1996 and 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 Dysport were analysed. Results: An average value of 153.4 units (Botox equivalent dose) was used. The patients felt the first improvement after 8.7 days and they returned to their baseline conditions before injection after 2.9 months. Patients expressed 57.5% improvement on average on a visual analog scale. While no side effects were observed in 72.3% of injections, dysphagia was seen in 8.3%, neck pain in 7.7%, weakness in the neck and neck drop in 5.1%,, a change in the type of dystonia in % 3.2, and dry mouth in 2.2%. Aphonia, prickling in the neck, vertigo, itching, ptosis, fatigue, stuffiness, atrophy in neck muscles, syncope during injection was observed in 1.2% of patients. When commercial preperations were compared, average improvement was 58.7% with Botox and 44.1% with Dysport, duration of improvement was 2.9 months with Botox versus 2.3 months with Dysport, and frequency of adverse effects was 25.3% with Botox compared with % 62.5 with Dysport. Discussion: 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. In our opinion, the reason Botox is more effective with less frequent adverse effects, in this study, is our having less experience with Dysport and using the incorrect dilution ratio of 1/5 at the time when the study was conducted.