Botulinum toxin a in non-dystonic tremors

被引:42
作者
Henderson, JM
Ghika, JA
VanMelle, G
Haller, E
Einstein, R
机构
[1] CHU VAUDOIS,POLICLIN NEUROL,CH-1011 LAUSANNE,SWITZERLAND
[2] INST UNIV MED SOCIALE & PREVENT,CH-1005 LAUSANNE,SWITZERLAND
[3] UNIV SYDNEY,DEPT PHARMACOL,SYDNEY,NSW 2006,AUSTRALIA
关键词
botulinum toxin A; placebo; non-dystonic tremors; accelerometry; surface electromyography;
D O I
10.1159/000117196
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The present pilot study evaluated the effect of botulinum toxin A on primarily non-dystonic tremors using accelerometry in a single-blind, placebo-controlled design. Resting, postural, intention, or head tremor were assessed before and approximately 1 month after intramuscular saline and botulinum toxin A (25-50 U) respectively. Half of the patients showed greater than or equal to 30% placebo effect. Tremor in 10 of 17 patients (60%) studied improved further after botulinum toxin A (range 30-95%), exceeding the placebo effect by greater than or equal to 30%. Nine patients demonstrated clinically significant focal weakness in the extensor muscles after botulinum toxin A which interfered with fine movements. Patients were subdivided into PD-like and ET-like tremor(s). Both groups experienced large placebo effects for resting tremor, with little or no further improvement after botulinum toxin A. The improvement in postural tremor after botulinum toxin A, of 40% in the PD-like and 57% in the ET-like groups, however, was approximately twice that of placebo. In conclusion, botulinum toxin A exerts a modest tremorlytic effect, however the dose, and its distribution over the sites injected, need to be optimised to minimise focal weakness.
引用
收藏
页码:29 / 35
页数:7
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