scholarly journals ANXIETY AND DEPRESSIVE DISORDERS IN PATIENTS WITH CRANIOCERVICAL DYSTONIA: CLINICAL AND ANAMNESTIC FEATURES AND MODIFYING ROLE OF BOTULINUM TOXIN THERAPY

2019 ◽  
Vol LI (1) ◽  
pp. 25-31 ◽  
Author(s):  
Zifa G Khaiatova ◽  
Zuleikha A Zalyalova
Keyword(s):  
Botulinum Toxin ◽  
Cervical Dystonia ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Spasmodic Torticollis ◽  
Depression And Anxiety ◽  
Botulinum Toxin Therapy ◽  
Botulinum Toxin Treatment ◽  
Craniocervical Dystonia

The study included 54 patients with cranio-cervical dystonia, 38 (70.4%) of whom were women, 16 (29.6%) - men, mean age 49,8 ± 11,3 years. 32 patients were diagnosed with cervical dystonia, groups with blepharospasm and Meige’s syndrome included 11 patients respectively. All patients were screened by «Unified Dystonia Rating Scale» and those who had cervical dystonia also by «Toronto western spasmodic torticollis rating scale (TWSTRS)». Psychoemotional state in these patients was examined by Beck depression inventory (BDI) and Hamilton’s anxiety rating scale (HAM-A). Depression and anxiety occurrence and severity was evaluated, impact of different factors including Botulinum toxin treatment was observed. Results of the study confirmed that anxiety and depressive disorders are associated with craniocervical dystonia. Sex, localization of dystonia, disease duration, and satisfaction with the treatment do not affect significantly severity of anxiety and depression. Regular injections of Botulinum toxin significantly decrease severity of psychoemotional disorders in these patients.

scholarly journals The Role of Ultrasound for the Personalized Botulinum Toxin Treatment of Cervical Dystonia

Toxins ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 365
Author(s):  
Urban M. Fietzek ◽  
Devavrat Nene ◽  
Axel Schramm ◽  
Silke Appel-Cresswell ◽  
Zuzana Košutzká ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Botulinum Toxin ◽  
Cervical Dystonia ◽  
Muscle Function ◽  
Current Evidence ◽  
Botulinum Toxin Therapy ◽  
Botulinum Toxin Treatment ◽  
Ongoing Development ◽  
Technical Considerations

The visualization of the human body has frequently been groundbreaking in medicine. In the last few years, the use of ultrasound (US) imaging has become a well-established procedure for botulinum toxin therapy in people with cervical dystonia (CD). It is now undisputed among experts that some of the most relevant muscles in this indication can be safely injected under visual US guidance. This review will explore the method from basic technical considerations, current evidence to conceptual developments of the phenomenology of cervical dystonia. We will review the implications of introducing US to our understanding of muscle function and anatomy of common cervical dystonic patterns. We suggest a flow chart for the use of US to achieve a personalized treatment of people with CD. Thus, we hope to contribute a resource that is useful in clinical practice and that stimulates the ongoing development of this valuable technique.

scholarly journals The physical, social and emotional aspects are the most affected in the quality of life of the patients with cervical dystonia

2014 ◽  
Vol 72 (6) ◽  
pp. 405-410 ◽  
Author(s):  
Roberta Weber Werle ◽  
Sibele Yoko Mattozo Takeda ◽  
Marise Bueno Zonta ◽  
Ana Tereza Bittencourt Guimarães ◽  
Hélio Afonso Ghizoni Teive
Keyword(s):  
Quality Of Life ◽  
Cervical Dystonia ◽  
Rating Scale ◽  
Motor Impairment ◽  
Residual Effect ◽  
Spasmodic Torticollis ◽  
Social And Emotional ◽  
Emotional Aspects ◽  
Craniocervical Dystonia

Objective : Describe the functional, clinical and quality of life (QoL) profiles in patients with cervical dystonia (CD) with residual effect or without effect of botulinum toxin (BTX), as well as verify the existence of correlation between the level of motor impairment, pain and QoL. Method : Seventy patients were assessed through the Craniocervical dystonia questionnaire-24 (CDQ-24) and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Results : The greater the disability, pain and severity of dystonia, the worse the QoL (p<0.0001). Greater severity relates to greater disability (p<0.0001). Pain was present in 84% of the sample, being source of disability in 41%. The most frequent complaints were: difficulty in keeping up with professional and personal demands (74.3%), feeling uneasy in public (72.9%), hindered by pain (68.6%), depressed, annoyed or bitter (47.1%), lonely or isolated (32.9%). Conclusion : The physical, social and emotional aspects are the most affected in the QoL of these patients.

Optimization of diagnosing and treatment of cervical dystonia

2020 ◽  
Vol 18 (5) ◽  
pp. 110-116
Author(s):  
С. М. М. СЕХВЕЙЛ ◽  
◽  
З. А. ГОНЧАРОВА ◽  
И. М. БЛИНОВ ◽  
◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Botulinum Toxin ◽  
Cervical Dystonia ◽  
Rating Scale ◽  
Botulinum Toxin Type A ◽  
Pain Syndrome ◽  
Botulinum Toxin Type ◽  
Botulinum Toxin Therapy ◽  
Before And After

The purpose is to optimize diagnostics of cervical dystonia using multispiral computed tomography (MSCT) of the cervical spine to improve the results of botulinum toxin therapy. Material and methods. 27 patients diagnosed with the idiopathic CD (21 females among them) were examined. The age of patients ranged from 25 to 72 years old (the average age was 40 (3,3)). All the patients were scanned with 3D multispiral computed tomography (MSCT) of the cervical spine in order to verify the dystonic muscles and determine the degree of head and neck rotation. MSCT helped to identify the cervical spine deformation, the level of its displacement and the state of dystonic muscles. The Tsui et al. rating scale was used for assessing the severity of CD before and after the treatment. Also the intensity of pain syndrome was assessed according to the visual analogue scale (VAS) before and after the treatment. All the patients had injections of botulinum toxin type A, in the dose 200–300 U. The time period between the injections was 3,5–4 months. Results. The study revealed that women tend to have cervical dystonia more often (77,8%). Late diagnostics of the disease still remains. The duration of the disease lasted from 1 month to 18 years. Before the treatment the pain syndrome intensity amounted to 5,6 (0,8) points, according to VAS, whereas after the treatment it was 1,9 (0,8) points. The 3D MSCT revealed the deformation of the cervical spine. MSCT helped to verify the dystonic muscles (a bigger surface of the dystonic muscle in comparison with the healthy part, a more «round» image of the muscle). MSCT of the cervical spine enabled to verify the form of dystonia (caput, collis or their combination). Conclusions. Late diagnostics of CD remains. Botulinum toxin therapy is a highly effective way of CD treatment. The efficiency of the botulinum toxin therapy in the given category of patients depends on the right choice of target muscles, the verification of the form of CD and adherence to the early treatment principle.

scholarly journals The effect of physical therapy in the treatment of patients with cervical dystonia with or without concomitant use of botulinum toxin

2018 ◽  
Vol 75 (10) ◽  
pp. 1035-1040
Author(s):  
Ivona Stankovic ◽  
Hristina Colovic ◽  
Vesna Zivkovic ◽  
Jelena Stamenovic ◽  
Anita Stankovic ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Physical Therapy ◽  
Cervical Dystonia ◽  
Rating Scale ◽  
Spasmodic Torticollis ◽  
Control Group ◽  
Limited Effect ◽  
Parallel Application ◽  
Randomized Controlled ◽  
Experimental Group

Background/Aim. Botulinum toxin is a basic, recommended method of treatment in controlling cervical dystonia (CD). Physical therapy has limited effect due to the nature of the disease that is a result of a disorder in structures and relationships of the basal ganglia. The aim of this study was to analyze the effect of physical therapy applied as monotherapy, or with parallel application of botulinum toxin in patients with CD. Methods. Randomized controlled clinical pilot study included 14 patients diagnosed with idiopathic CD. All patients were initially assessed by using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Torticollis Rating Scale (Tsui scale). In the control group, composed of 5 patients, the treatment included only physical therapy. The experimental group (9 patients) was first given botulinum toxin, and physical therapy was applied after five days. Physical therapy was conducted five times a week in the period of two weeks at the Clinic. Patients of both groups were instructed to continue with the physical therapy at home. The effects of treatment were analyzed after 1, 3 and 6 months using TWSTRS and Tsui scale. Results. At the beginning of the investigation, the differences in TWSTRS and Tsui scale between the groups were not significant. In the control group, after 1 month, significant improvement was achieved in all three parts of the TWSTRS. After 3 and 6 months, the effects of physical therapy were reduced to control levels. In the experimental group, highly significant increase of all parameters of TWSTRS was noted after 1, 3 and 6 months. In the control group, highly significant decrease of changes in Tsui scale was noticed only after one month while in the experimental group, it was maintained after 3 and 6 months. Conclusion. Application of physical therapy provides a significant improvement in disease severity, but the effect is better and of longer duration when combined with the botulinum toxin.

scholarly journals P.037 Benefits of Treatment with OnabotulinumtoxinA in Naive and Non-naive Patients with Cervical Dystonia are Sustained over Time in CD PROBE

2021 ◽  
Vol 48 (s3) ◽  
pp. S30-S31
Author(s):  
P Agarwal ◽  
M Schwartz ◽  
A Zuzek ◽  
A Patel
Keyword(s):  
Botulinum Toxin ◽  
Cervical Dystonia ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Spasmodic Torticollis ◽  
Time Interval ◽  
Median Time Interval ◽  
Sustained Effects ◽  
Severity Scores ◽  
Toxin Exposure

Background: The sustained effects of onabotulinumtoxinA in patients with cervical dystonia (CD) who were naïve or non-naïve to botulinum toxin at enrollment in CD PROBE (CD Patient Registry for Observation of BOTOX® Efficacy) were evaluated. Methods: Patients were included if they completed all three treatment cycles and had accompanying data in this prospective, observational study. Assessments included CD severity, Cervical Dystonia Impact Profile (CDIP-58), Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), treatment interval, total dose, and adverse events (AEs). Results: Changes in severity following each onabotulinumtoxinA treatment were generally similar between naïve (n=212) and non-naïve (n=138) patients. Severity scores were maintained or improved in most patients with mild/moderate symptoms, while 30.0-66.7% with the highest severity scores shifted to a lower score across treatments. Sustained improvements were seen in all CDIP-58 subscales and TWSTRS total scores irrespective of baseline CD severity and toxin status. The median time interval between injections was similar in naïve (93.0–98.0 days) and non-naïve patients (96.0–97.0 days); doses tended to be lower in naïve patients. The most common AEs (dysphagia, muscular weakness) were similar. Conclusions: CD severity was attenuated by repeat onabotulinumtoxinA treatments at consistent intervals regardless of prior botulinum toxin exposure. Treatments were well tolerated.

scholarly journals Quality of life in individuals with cervical dystonia before botulinum toxin injection in a Brazilian tertiary care hospital

2011 ◽  
Vol 69 (6) ◽  
pp. 900-904 ◽  
Author(s):  
Mariana Ribeiro Queiroz ◽  
Hsin Fen Chien ◽  
Egberto Reis Barbosa
Keyword(s):  
Quality Of Life ◽  
Botulinum Toxin ◽  
Cervical Dystonia ◽  
Rating Scale ◽  
Short Form ◽  
Tertiary Care ◽  
Residual Effect ◽  
Care Hospital ◽  
Sf 36

OBJECTIVE: The purpose of this study was to evaluate quality of life (QoL) in a Brazilian population of individuals with cervical dystonia (CD) without effect of botulinum toxin (BTx) or with only residual effect of BTx, and identify possible physical and social aspects that affect their QoL. METHOD: Sixty five out of sixty seven consecutive patients with CD were assessed with two instruments: Short-form Health Survey with 36 questions (SF-36) and Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). RESULTS: Severity of CD (TWSTRS) correlated moderately with two SF-36 subscale: role-physical (r= -0.42) and body pain (r= -0.43). Women also scored worse in two subscale of SF-36: vitality (p<0.05) and mental-health (p<0.005). CONCLUSION: Severity of CD and gender (female) were the main factors related to a worse QoL perception. These findings may help health professionals to predict which characteristics could lead to worse QoL, and therefore, better target their interventions to lessen the burden caused by CD.

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