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Botulinum toxin in the treatment of tics.

Publication ,  Journal Article
Kwak, CH; Hanna, PA; Jankovic, J
Published in: Arch Neurol
August 2000

OBJECTIVE: To evaluate the safety and efficacy of botulinum toxin A (BTX) injections in the treatment of tics in patients with Tourette syndrome (TS). BACKGROUND: BTX is an effective treatment for an increasing number of conditions characterized by abnormal muscle contractions. BTX may improve not only the motor component of tics, but also premonitory sensations that precede tics. METHODS: Thirty-five patients (30 male, 5 female) were treated with BTX in the sites of their most problematic tics. Response to BTX was based on a 0 to 4 clinical rating scale (0, no improvement, to 4, marked improvement in both severity and function). Questionnaires were administered to evaluate patients' impressions of overall efficacy and degree of benefit with premonitory sensations. RESULTS: Mean duration of tics prior to initial injection was 15.3 years (range, 1-62 years) and mean duration of follow-up was 21.2 months (range, 1. 5-84 months). The mean peak effect response in 35 patients treated in 115 sessions was 2.8 (range, 0-4); the mean duration of benefit was 14.4 weeks (maximum, 45 weeks); and the mean latency to onset of benefit was 3.8 days (maximum, 10 days). Twenty-one (84%) of 25 patients with premonitory sensations derived marked relief of these symptoms (mean benefit, 70.6%). Total mean dose was 502.1 U (range, 15-3550 U); mean number of visits, 3.3 (range, 1-16); and mean dose per visit, 119.9 U (range, 15-273 U). Sites of injections were as follows: cervical or upper thoracic area (17), upper face (14), lower face (7), vocal cords (4), upper back and/or shoulder (3), scalp (1), forearm (1), leg (1) and rectus abdominis (1). Complications included neck weakness (4), dysphagia (2), ptosis (2), nausea (1), hypophonia (1), fatigue (1), and generalized weakness (1), which were all mild and transient. CONCLUSIONS: Botulinum toxin A injections are an effective and well-tolerated treatment of tics. In addition to improving the motor component of tics, BTX also provides relief of premonitory sensations. Arch Neurol. 2000;57:1190-1193

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Published In

Arch Neurol

DOI

ISSN

0003-9942

Publication Date

August 2000

Volume

57

Issue

8

Start / End Page

1190 / 1193

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tourette Syndrome
  • Tics
  • Patient Satisfaction
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Kwak, C. H., Hanna, P. A., & Jankovic, J. (2000). Botulinum toxin in the treatment of tics. Arch Neurol, 57(8), 1190–1193. https://doi.org/10.1001/archneur.57.8.1190
Kwak, C. H., P. A. Hanna, and J. Jankovic. “Botulinum toxin in the treatment of tics.Arch Neurol 57, no. 8 (August 2000): 1190–93. https://doi.org/10.1001/archneur.57.8.1190.
Kwak CH, Hanna PA, Jankovic J. Botulinum toxin in the treatment of tics. Arch Neurol. 2000 Aug;57(8):1190–3.
Kwak, C. H., et al. “Botulinum toxin in the treatment of tics.Arch Neurol, vol. 57, no. 8, Aug. 2000, pp. 1190–93. Pubmed, doi:10.1001/archneur.57.8.1190.
Kwak CH, Hanna PA, Jankovic J. Botulinum toxin in the treatment of tics. Arch Neurol. 2000 Aug;57(8):1190–1193.

Published In

Arch Neurol

DOI

ISSN

0003-9942

Publication Date

August 2000

Volume

57

Issue

8

Start / End Page

1190 / 1193

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tourette Syndrome
  • Tics
  • Patient Satisfaction
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
  • Female