Abstract

Objectives: In this study we aimed to identify clinical and demographic characteristics of patients with cervical dystonia (CD) and evaluate their response to treatment with botulinum toxin type A (BoNT/A). We also compared the outcomes of the patients with a disease duration of <5 years and ≥5 years and the patients receiving BoNT/A treatment for <5 years and ≥5 years.

Patients and Methods: Between March 2001 and December 2011, the data obtained from 17 patients with CD (11 females, 6 males; mean age 48.2±12.0 years) who visited Bezmialem Vakif University, School of Medicine, Department of Neurology, Botulinum Toxin Outpatient Clinic were retrospectively analyzed. Detailed clinical and demographic information were obtained for each patient.

Results: The mean age at onset of CD was 39.1±11.6 years. The mean disease duration was 9.1±4.1 years. Nine patients had right-sided CD. The mean time from the onset of the symptoms to BoNT/A treatment was 4.5±3.6 years. The mean duration of BoNT/A treatment was 4.6±2.9 years. Two different brands of BoNT/A (Botox® and Dysport®) were used with a mean dose ratio of 4 between toxins. A total of 181 BoNT/A treatments with multiple sites injections were administered during this period. The mean response rate was assessed based on a five-point scale at each visit. After the last injection, the mean response rate was 3.1±0.5 and the mean total duration of response was 3.0±1.9 months. After dosage adjustment, a significant increase was found between the mean dose injected (531.2±230.2 versus 788.5±259 units; p=0.01) of BoNT/A and the number of muscle (2.7±0.7 versus 3.8±0.8) in the first and last injections (p=0.005).

Conclusion: Our results showed that a statistically significant increase was found between the mean dose of BoNT/A and the number of muscles over time.