Abstract
To study the jitter parameters in the distant (DM) and the adjacent muscle (AM) after botulinum neurotoxin type A (BoNT/A) injection in 78 patients, jitter was measured by voluntary activation in DM (n = 43), and in AM (n = 35). Patients were receiving BoNT/A injections as a treatment for movement disorders. Mean age 65.1 years (DM) and 61.9 years (AM). The mean jitter was abnormal in 13.9% (maximum 41.4 µs) of DM, and 40% (maximum 43.7 µs) of AM. Impulse blocking was sparse. We found no correlation of the mean jitter to age, BoNT/A most recent injection (days/units), number of muscles injected, total BoNT/A units summated, number of total BoNT/A sessions, beta-blockers/calcium channel blockers use, and cases with local spread symptoms such as eyelid drop/difficulty swallowing. Maximum mean jitter (41.4/43.7 µs) for DM/AM occurred 61 and 131 days since the most recent BoNT/A, respectively. The far abnormal mean jitter (32.6/36.9 µs) occurred 229 and 313 days since the most recent BoNT/A. We suggested that jitter measurement can be done after BoNT/A in a given muscle other than the injected one, after 8 (DM) and 11 (AM) months, with reference >33 µs and >37 µs, respectively.
Highlights
In 1977, Scott et at. [1], seeking a pharmacological alternative for strabismus correction, found an extraordinary benefit from a botulinum neurotoxin type A (BoNT/A) injection into the rectus muscles in adult rhesus monkeys
We found no relationship between cases with spread symptoms to the mean jitter values
Our results revealed that a relatively mild mean jitter increased in 13.9% of patients from the distant group, in which the BoNT/A was injected mostly in facial or neck muscle, and the jitter was distant group, in which the BoNT/A was injected mostly in facial or neck muscle, and the jitter was measured in a limb muscle, mostly ED
Summary
In 1977, Scott et at. [1], seeking a pharmacological alternative for strabismus correction, found an extraordinary benefit from a botulinum neurotoxin type A (BoNT/A) injection into the rectus muscles in adult rhesus monkeys. [1], seeking a pharmacological alternative for strabismus correction, found an extraordinary benefit from a botulinum neurotoxin type A (BoNT/A) injection into the rectus muscles in adult rhesus monkeys. Symptoms from many movement disorders have been greatly minimized from the BoNT/A injections. Botulinum neurotoxin high efficacy occurs because it has high specificity for skeletal and autonomic cholinergic nerves. It does not spread in high amounts outside the injection site, and it is poorly immunogenic [2,3]. Clostridium botulinum produces eight immunologically distinct serotypes (type A–H) that differ from each other by the nontoxic accessory protein (NAP) composition. The BoNT/A is the most used and presented as onabotulinumtoxinA (ONA), abobotulinum toxin A
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