Botulinum toxin induced therapy failure type B antibody (BT-B, BT-B-AB) has so far only been reported after previous formation of antibodies against botulinum toxin type A (BT-A, BTA-AB).We wanted to explore the risk ...Botulinum toxin induced therapy failure type B antibody (BT-B, BT-B-AB) has so far only been reported after previous formation of antibodies against botulinum toxin type A (BT-A, BTA-AB).We wanted to explore the risk of BT-B-AB-induced therapy failure in patients who were exposed to botulinum toxin for the first time. For this purpose we followed nine patients with cervical dystonia receiving BT-B (NeuroBloc/Myo BlocTM, Elan Pharmaceuticals) in a dose of 11435 ±2977MU during 4.9 ±.3.0 injection series. All patients showed a satisfactory initial therapeutic response as documented by a Toronto Western Spasmodic Torticollis Rating Scale score reduction from 17.7 ±9.4 to 5.3 ±4.8 and an overall subjective improvement of 56.1 ±28.3%. Seven patients experienced systemic anticholinergic side effects. Five patients had stable therapeutic responses over subsequent injection series. Four patients experienced complete therapy failure with BT-B-AB titres in excess of 10mU/ml on the mouse diaphragm assay. Doubling the last effective BT-B dose produced neither therapeutic effects nor side effects. Subsequent applications of botulinum toxin type A produced a continued therapeutic response in one patient and complete therapy failure in the other. Despite the small sample size a frequency of 44 %indicates a high risk for BT-B-AB-in- duced complete therapy failure. The high amount of neurotoxin administered when NeuroBloc/MyoBlocTM is used might be a contributory factor. Further prospective comparative studies are necessary to monitor the frequency and time course of BT-B-AB formation.展开更多
We introduced our new concept for acupuncture therapy in patients with cervical dystonia. It is important to accurately distinguish primary disorders from secondary using clinical evaluations and EMG findings on so-ca...We introduced our new concept for acupuncture therapy in patients with cervical dystonia. It is important to accurately distinguish primary disorders from secondary using clinical evaluations and EMG findings on so-called motion analysis. Retaining needles on the meridian points based om the meridian concept was used for the primary problem as hypertonus or hypotonus or unsustained head movement.展开更多
文摘Botulinum toxin induced therapy failure type B antibody (BT-B, BT-B-AB) has so far only been reported after previous formation of antibodies against botulinum toxin type A (BT-A, BTA-AB).We wanted to explore the risk of BT-B-AB-induced therapy failure in patients who were exposed to botulinum toxin for the first time. For this purpose we followed nine patients with cervical dystonia receiving BT-B (NeuroBloc/Myo BlocTM, Elan Pharmaceuticals) in a dose of 11435 ±2977MU during 4.9 ±.3.0 injection series. All patients showed a satisfactory initial therapeutic response as documented by a Toronto Western Spasmodic Torticollis Rating Scale score reduction from 17.7 ±9.4 to 5.3 ±4.8 and an overall subjective improvement of 56.1 ±28.3%. Seven patients experienced systemic anticholinergic side effects. Five patients had stable therapeutic responses over subsequent injection series. Four patients experienced complete therapy failure with BT-B-AB titres in excess of 10mU/ml on the mouse diaphragm assay. Doubling the last effective BT-B dose produced neither therapeutic effects nor side effects. Subsequent applications of botulinum toxin type A produced a continued therapeutic response in one patient and complete therapy failure in the other. Despite the small sample size a frequency of 44 %indicates a high risk for BT-B-AB-in- duced complete therapy failure. The high amount of neurotoxin administered when NeuroBloc/MyoBlocTM is used might be a contributory factor. Further prospective comparative studies are necessary to monitor the frequency and time course of BT-B-AB formation.
文摘We introduced our new concept for acupuncture therapy in patients with cervical dystonia. It is important to accurately distinguish primary disorders from secondary using clinical evaluations and EMG findings on so-called motion analysis. Retaining needles on the meridian points based om the meridian concept was used for the primary problem as hypertonus or hypotonus or unsustained head movement.
