Abstract
Botulinum toxin A (BoNT-A) has become the first-line therapy in cervical dystonia (CD), blepharospasm and spasticity. However, the current guidelines for the clinical use of BoNT-A are based on data published more than 20 years ago and patient satisfaction with current treatment regimens is low. There is a striking difference between the injection intervals given in everyday clinical practice and the injection intervals preferred by patients. Recent data have indicated that shorter injection intervals may improve overall patient satisfaction since re-emergence of symptoms could be prevented. Three double-blind studies have demonstrated that incobotulinumtoxin A (incoBoNT-A) is suitable for use in a flexible, patient-centric approach in blepharospasm and CD, with injection intervals starting from 6 weeks. The efficacy, tolerability and safety of this regime were excellent. There is a need to optimise and individualise the treatment using the three available formulations of BoNT- A, as well as to define parameters for switching between the formulations.
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