Botulinum toxin type a: an experience with 2.000 injections

Toxina botulínica tipo a: experiencia con 2.000 aplicaciones

Botulinum toxin type A is used extensively for the management of motility disorders constituting an important thera­ peutic tool. This report shows the experience, results and conclusions obtained at the neurology service of Hospital de San José de Bogotá DC, through 2.000 botulinum toxin injections to treat dystonia, spasticity and migraine. Hemifacial spasm improved between 60 and 80%, blepharospasm between 70 and 90%, cervical dystonia between 70 and 80%, and complex dystonia (deterioration of two or more movement patterns) from 50 to 60%. lmprovement in spasticity was evidenced by increased range of motion measured with a goniometer before and after the injection. Spasticity improvement varied according to the rate of progression, severity and spasticity pattern. Follow-up was conducted using the gross motor function classification system (GMFCS). Total remission of pain was achieved in 60 % of patients with chronic daily headaches, was significantly reduced in 30% and did not improve in 10%. Conclusions: botulinum toxin injection appears to be safe and must be a dynamic process adjusted to each patient needs. Therapeutic effects are evidenced on the second day after injection and maximum expression is seen on day 14. Duration of effect ranges from 2 to 6 months with a media of 2.8. Adverse effects fade about 30 days after injection.

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