Abstract
The objective of this study is to investigate the efficacy of botulinum toxin A (BTXA) injections in patients with progressive supranuclear palsy (PSP) and multisystem atrophy (MSA) complaining of pain, unresponsive to oral drug therapy. Ten patients with functionally disabling abnormal neck postures were included. Patients were diagnosed according to established criteria and had disabling antecollis ( n : 7, MSA) or retrocollis ( n : 3, PSP) associated with pain and difficulty in feeding and performing activities of daily living. Site and dose of BTXA injections were determined individually, based on clinical examination as well as EMG. A Pain Visual Analogue Scale (VAS) and Health-related Quality of Life Scale (HR-QoL PSP and MSA) were applied. BTXA reduced pain in all patients, subjectively and as demonstrated by improvement of VAS (60% improvement); HR PSP and MSA scores related to physical aspects and social impairment (50% improvement). No adverse effects were observed. BTXA dosages were significantly lower than those usually used in cervical dystonia. Injection effects lasted for a mean of 5 months.
Published Version
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