Document Detail

Survey of practices employed by neurologists for the definition and management of secondary non-response to botulinum toxin in cervical dystonia.
MedLine Citation:
PMID:  23597436     Owner:  NLM     Status:  MEDLINE    
Secondary non-response (SNR) to botulinum toxin (BoNT) in cervical dystonia (CD) lacks a universal definition. We conducted a retrospective survey to develop a definition based on clinicians' practice. Fifty-seven neurologists completed a 17-item questionnaire. In defining SNR, insufficiently improved posture was considered to be more relevant (98% of physicians) than insufficiently improved pain (86%). The most frequently used diagnostic test for SNR was the frontalis test (68%); antibody testing was performed by only 13% of physicians. Three consecutive unsuccessful injection cycles were considered the most appropriate indicator of SNR (55% of physicians). Physicians reported that 5.9% (median) of patients treated in 2008 became secondary non-responders to BoNT-A. The most common strategy for SNR was optimization of physiotherapy, considered by 98% of the physicians. On the basis of our findings, SNR can be defined as insufficiently improved posture after ≥3 unsuccessful injection cycles in CD patients previously achieving satisfactory results.
Joaquim J Ferreira; Roongroj Bhidayasiri; Carlo Colosimo; Maria Jose Marti; Benjamin Zakine; Pascal Maisonobe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Functional neurology     Volume:  27     ISSN:  0393-5264     ISO Abbreviation:  Funct. Neurol.     Publication Date:    2012 Oct-Dec
Date Detail:
Created Date:  2013-04-19     Completed Date:  2013-06-18     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  8707746     Medline TA:  Funct Neurol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  225-30     Citation Subset:  IM    
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MeSH Terms
Anti-Dyskinesia Agents / adverse effects*
Botulinum Toxins / adverse effects*
Health Surveys
Pain Measurement
Physicians / psychology*
Retrospective Studies
Torticollis / diagnosis*,  drug therapy*
Reg. No./Substance:
0/Anti-Dyskinesia Agents; EC Toxins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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