Occurrence of Dysphagia Following Botulinum Toxin Injection in Parkinsonism-related Cervical Dystonia: A Retrospective Study. (3rd November 2016)

• Record Type: Journal Article
• Authors: Patterson, Addie; Almeida, Leonardo; Hess, Christopher W.; Martinez-Ramirez, Daniel; Okun, Michael S.; Rodriguez, Ramon L.; Rundle-Gonzalez, Valerie; Shukla, Aparna Wagle; Malaty, Irene A.
• Editors: Louis, Elan D.
• Is Part Of: Tremor and other hyperkinetic movements. Volume 6(2016)
• Publication Date: 2016-11-03
• Subjects: Parkinson's disease -- parkinsonism -- cervical dystonia -- botulinum toxin -- dysphagia; Tremor -- Periodicals; Hyperkinesia -- Periodicals; 616.8
• DOI: 10.7916/D8GB24C5
• Languages: English
• ISSNs: 2160-8288

Abstract

Background: The aim was to compare the occurrence of post-injection dysphagia in parkinsonism-related cervical dystonia (PRCD) versus cervical dystonia (CD) of other etiologies (non-PRCD). A secondary objective was to explore potential clinical differences between PRCD and non-PRCD and their respective responses to botulinum toxin (BoNT). Methods: A cross-sectional chart review was carried out of patients treated for CD with Onabotulinumtoxin A at the University of Florida. We collected demographic information, dose of BoNT injected, patient-reported presence of dysphagia as a side effect, patient-perceived duration of benefit and efficacy according to the Clinical Global Impression Scale (CGIS). Results: Of the 144 patients included, 24 patients were diagnosed with PRCD and 120 were diagnosed as non-PRCD. Data analysis showed no significant differences in number of weeks of benefit from BoNT (PRCD 9.1±3.7 versus non-PRCD 9.4±3.7 weeks, p = 0.830), BoNT dosage (PRCD 235.0±95.6 versus non-PRCD 263.7±101.3 units, p = 0.181), median CGIS score (median = 2 or "much improved" for both groups, p = 0.88), or the presence of dysphagia after BoNT (PRCD 17% versus non-PRCD 19 %, p = 0.753, n = 132). In a subgroup analysis of the non-PRCD group, patients who experienced dysphagia were older than those who did not (63.9±8.9 years versus 58.1±14.4 years, p = 0.02). Discussion: Despite an increased baseline risk of dysphagia in patients with PRCD, BoNT appears to be equally safe and equally beneficial in PRCD and non-PRCD patients.