January 2012

Botulinum toxin type A in cervical dystonia

Authors: R.Marvulli, G.Ianieri, G.Megna, G.Lancioni, R.Saggini, M.Ranieri, G.Cristella, M.Megna

Affiliations: Neuroscience and Sense Organs Department Physical Medicine and Rehabilitation Bari “Aldo Moro” University, Italy; Department Physical medicine and Rehabilitation “G.D’annunzio” University Chieti, Italy; Osmairm Neuropsychomotor Rehabilitation Center, Laterza, Italy

Journal: International Journal of Immunopathology and Pharmacology - January 2012, Volume 25, No.1, Page 23-28 (DOI: 10.1177/03946320120250S104)

Cervical dystonia is a syndrome characterized by anomalous postures and unintentional repetitive movements of the head and the neck. Aim of this study is to show the effectiveness of the combined treatment botulinum toxin-FKT through the use of a recent methodic of investigation, myoton, and of the classical clinical evaluations, such as Tsui and VAS scales. 15 patients (9 females, 6 males) have been selected. During the initial visit and in the following controls, performed every month, patients have been submitted to physiatric examination, clinical evaluation of the dystonia through the Tsui scale, clinical evaluation of the pain through the VAS scale, myometric evaluation. We obtained statistically reduction of muscular tone’s value in passive elongation (t0=16,34±l,23) until 4 month (t4 =16,11±1,23), when we performed a second infiltration. After 4 months from the second infiltration (t8=15,99±1,11) value did not present more some statistical correlation and was necessary to perform a new infiltration. Values of elasticity, stiffness, Tsui and VAS scale followed the same course of the tone. Our study demonstrates that combined treatment botulinum toxin-FKT is effective. It emerges that if to the treatment with botulinum toxin follows a suitable FKT treatment, the effect of the drug lasts 4 months and not 3 months as described by the literature. Our study has underlined that using myometric measurement we can consider least changes in muscular tone, elasticity and stiffness; we have a broader view of the spastic muscle, and we can better plan appropriate rehabilitative care for each patient.

Keywords: cervical dystonia, muscular tone, botulinum toxin-FKT