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. 1995 Dec;59(6):601–607. doi: 10.1136/jnnp.59.6.601

Botulinum toxin F in the treatment of torticollis clinically resistant to botulinum toxin A.

G L Sheean 1, A J Lees 1
PMCID: PMC1073754  PMID: 7500097

Abstract

Two reports have shown a Japanese preparation of botulinum toxin type F (BTX-F) to be an effective alternative for patients with torticollis who develop clinical resistance to botulinum toxin type A (BTX-A). A group of patients with torticollis, comprising five secondary non-responders and one primary non-responder, were treated with a preparation of BTX-F produced in the UK (Speywood Pharmaceuticals). A low dose of BTX-F (220 mouse units (MU) in total) was given into clinically affected neck muscles, followed six weeks later by an injection of a total of 520 MU. Antibodies to BTX-A (mouse protection assay) were present in all secondary non-responders but not in the primary non-responder. No patients developed atrophy after injection of Dysport BTX-A (40 MU) into the left extensor digitorum brevis muscle whereas pronounced atrophy occurred in all patients after injection of 40 MU of BTX-F into the right extensor digitorum brevis muscle. Three patients improved subjectively after treatment with 220 MU BTX-F and five (all secondary non-responders) after the subsequent dose of 520 MU (two considerably), with reduced Tsui scores, but group scores were only significantly changed after the higher dose. The primary non-responder remained unchanged after both doses of BTX-F. One patient reported mild dysphagia with 520 MU BTX-F. Mean duration of improvement with 520 MU BTX-F was five (range 4-6)weeks. Thus BTX-F provides benefit for BTX-A non-responders with few side effects but for a shorter period than BTX-A, possibly due to relative underdosing. As with BTX-A, biological sensitivity to BTX-F does not necessarily predict a clinical response.

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Selected References

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  1. Anderson T. J., Rivest J., Stell R., Steiger M. J., Cohen H., Thompson P. D., Marsden C. D. Botulinum toxin treatment of spasmodic torticollis. J R Soc Med. 1992 Sep;85(9):524–529. [PMC free article] [PubMed] [Google Scholar]
  2. Berardelli A., Formica A., Mercuri B., Abbruzzese G., Agnoli A., Agostino R., Caraceni T., Carella F., De Fazio G., De Grandis D. Botulinum toxin treatment in patients with focal dystonia and hemifacial spasm. A multicenter study of the Italian Movement Disorder Group. Ital J Neurol Sci. 1993 Jun;14(5):361–367. doi: 10.1007/BF02340723. [DOI] [PubMed] [Google Scholar]
  3. Biglan A. W., Gonnering R., Lockhart L. B., Rabin B., Fuerste F. H. Absence of antibody production in patients treated with botulinum A toxin. Am J Ophthalmol. 1986 Feb 15;101(2):232–235. doi: 10.1016/0002-9394(86)90601-x. [DOI] [PubMed] [Google Scholar]
  4. Blackie J. D., Lees A. J. Botulinum toxin treatment in spasmodic torticollis. J Neurol Neurosurg Psychiatry. 1990 Aug;53(8):640–643. doi: 10.1136/jnnp.53.8.640. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cohen L. G., Hallett M., Geller B. D., Hochberg F. Treatment of focal dystonias of the hand with botulinum toxin injections. J Neurol Neurosurg Psychiatry. 1989 Mar;52(3):355–363. doi: 10.1136/jnnp.52.3.355. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Das T. K., Park D. M. Effect of treatment with botulinum toxin on spasticity. Postgrad Med J. 1989 Apr;65(762):208–210. doi: 10.1136/pgmj.65.762.208. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Elston J. S. The management of blepharospasm and hemifacial spasm. J Neurol. 1992 Jan;239(1):5–8. doi: 10.1007/BF00839203. [DOI] [PubMed] [Google Scholar]
  8. Gelb D. J., Lowenstein D. H., Aminoff M. J. Controlled trial of botulinum toxin injections in the treatment of spasmodic torticollis. Neurology. 1989 Jan;39(1):80–84. doi: 10.1212/wnl.39.1.80. [DOI] [PubMed] [Google Scholar]
  9. Glanzman R. L., Gelb D. J., Drury I., Bromberg M. B., Truong D. D. Brachial plexopathy after botulinum toxin injections. Neurology. 1990 Jul;40(7):1143–1143. doi: 10.1212/wnl.40.7.1143. [DOI] [PubMed] [Google Scholar]
  10. Gonnering R. S. Negative antibody response to long-term treatment of facial spasm with botulinum toxin. Am J Ophthalmol. 1988 Mar 15;105(3):313–315. doi: 10.1016/0002-9394(88)90016-5. [DOI] [PubMed] [Google Scholar]
  11. Greene P. E., Fahn S. Use of botulinum toxin type F injections to treat torticollis in patients with immunity to botulinum toxin type A. Mov Disord. 1993 Oct;8(4):479–483. doi: 10.1002/mds.870080411. [DOI] [PubMed] [Google Scholar]
  12. Greene P., Fahn S., Diamond B. Development of resistance to botulinum toxin type A in patients with torticollis. Mov Disord. 1994 Mar;9(2):213–217. doi: 10.1002/mds.870090216. [DOI] [PubMed] [Google Scholar]
  13. Greene P., Kang U., Fahn S., Brin M., Moskowitz C., Flaster E. Double-blind, placebo-controlled trial of botulinum toxin injections for the treatment of spasmodic torticollis. Neurology. 1990 Aug;40(8):1213–1218. doi: 10.1212/wnl.40.8.1213. [DOI] [PubMed] [Google Scholar]
  14. Hambleton P., Cohen H. E., Palmer B. J., Melling J. Antitoxins and botulinum toxin treatment. BMJ. 1992 Apr 11;304(6832):959–960. doi: 10.1136/bmj.304.6832.959-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Jankovic J. Botulinum A toxin in the treatment of blepharospasm. Adv Neurol. 1988;49:467–472. [PubMed] [Google Scholar]
  16. Jankovic J., Brin M. F. Therapeutic uses of botulinum toxin. N Engl J Med. 1991 Apr 25;324(17):1186–1194. doi: 10.1056/NEJM199104253241707. [DOI] [PubMed] [Google Scholar]
  17. Jankovic J., Orman J. Botulinum A toxin for cranial-cervical dystonia: a double-blind, placebo-controlled study. Neurology. 1987 Apr;37(4):616–623. doi: 10.1212/wnl.37.4.616. [DOI] [PubMed] [Google Scholar]
  18. Jankovic J., Schwartz K. S. Clinical correlates of response to botulinum toxin injections. Arch Neurol. 1991 Dec;48(12):1253–1256. doi: 10.1001/archneur.1991.00530240057020. [DOI] [PubMed] [Google Scholar]
  19. Karp B. I., Cole R. A., Cohen L. G., Grill S., Lou J. S., Hallett M. Long-term botulinum toxin treatment of focal hand dystonia. Neurology. 1994 Jan;44(1):70–76. doi: 10.1212/wnl.44.1.70. [DOI] [PubMed] [Google Scholar]
  20. Kauffman J. A., Way J. F., Jr, Siegel L. S., Sellin L. C. Comparison of the action of types A and F botulinum toxin at the rat neuromuscular junction. Toxicol Appl Pharmacol. 1985 Jun 30;79(2):211–217. doi: 10.1016/0041-008x(85)90342-4. [DOI] [PubMed] [Google Scholar]
  21. Lorentz I. T., Subramaniam S. S., Yiannikas C. Treatment of idiopathic spasmodic torticollis with botulinum toxin A: a double-blind study on twenty-three patients. Mov Disord. 1991;6(2):145–150. doi: 10.1002/mds.870060210. [DOI] [PubMed] [Google Scholar]
  22. Ludlow C. L., Hallett M., Rhew K., Cole R., Shimizu T., Sakaguchi G., Bagley J. A., Schulz G. M., Yin S. G., Koda J. Therapeutic use of type F botulinum toxin. N Engl J Med. 1992 Jan 30;326(5):349–350. doi: 10.1056/NEJM199201303260516. [DOI] [PubMed] [Google Scholar]
  23. Mezaki T., Kaji R., Kohara N., Fujii H., Katayama M., Shimizu T., Kimura J., Brin M. F. Comparison of therapeutic efficacies of type A and F botulinum toxins for blepharospasm: a double-blind, controlled study. Neurology. 1995 Mar;45(3 Pt 1):506–508. doi: 10.1212/wnl.45.3.506. [DOI] [PubMed] [Google Scholar]
  24. Moore A. P., Blumhardt L. D. A double blind trial of botulinum toxin "A" in torticollis, with one year follow up. J Neurol Neurosurg Psychiatry. 1991 Sep;54(9):813–816. doi: 10.1136/jnnp.54.9.813. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Rivest J., Lees A. J., Marsden C. D. Writer's cramp: treatment with botulinum toxin injections. Mov Disord. 1991;6(1):55–59. doi: 10.1002/mds.870060110. [DOI] [PubMed] [Google Scholar]
  26. Sampaio C., Castro-Caldas A., Sales-Luis M. I., Alves M., Pinto L., Apolinario P. Brachial plexopathy after Botulinum toxin administration for cervical dystonia. J Neurol Neurosurg Psychiatry. 1993 Feb;56(2):220–220. doi: 10.1136/jnnp.56.2.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Sheean G. L., Murray N. M., Marsden C. D. Pain and remote weakness in limbs injected with botulinum toxin A for writer's cramp. Lancet. 1995 Jul 15;346(8968):154–156. doi: 10.1016/s0140-6736(95)91212-6. [DOI] [PubMed] [Google Scholar]
  28. Siatkowski R. M., Tyutyunikov A., Biglan A. W., Scalise D., Genovese C., Raikow R. B., Kennerdell J. S., Feuer W. J. Serum antibody production to botulinum A toxin. Ophthalmology. 1993 Dec;100(12):1861–1866. doi: 10.1016/s0161-6420(93)31384-9. [DOI] [PubMed] [Google Scholar]
  29. Siegel L. S. Evaluation of neutralizing antibodies to type A, B, E, and F botulinum toxins in sera from human recipients of botulinum pentavalent (ABCDE) toxoid. J Clin Microbiol. 1989 Aug;27(8):1906–1908. doi: 10.1128/jcm.27.8.1906-1908.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Snow B. J., Tsui J. K., Bhatt M. H., Varelas M., Hashimoto S. A., Calne D. B. Treatment of spasticity with botulinum toxin: a double-blind study. Ann Neurol. 1990 Oct;28(4):512–515. doi: 10.1002/ana.410280407. [DOI] [PubMed] [Google Scholar]
  31. Sugiyama H. Clostridium botulinum neurotoxin. Microbiol Rev. 1980 Sep;44(3):419–448. doi: 10.1128/mr.44.3.419-448.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Trosch R. M., Pullman S. L. Botulinum toxin A injections for the treatment of hand tremors. Mov Disord. 1994 Nov;9(6):601–609. doi: 10.1002/mds.870090604. [DOI] [PubMed] [Google Scholar]
  33. Troung D. D., Rontal M., Rolnick M., Aronson A. E., Mistura K. Double-blind controlled study of botulinum toxin in adductor spasmodic dysphonia. Laryngoscope. 1991 Jun;101(6 Pt 1):630–634. doi: 10.1288/00005537-199106000-00010. [DOI] [PubMed] [Google Scholar]
  34. Tsui J. K., Bhatt M., Calne S., Calne D. B. Botulinum toxin in the treatment of writer's cramp: a double-blind study. Neurology. 1993 Jan;43(1):183–185. doi: 10.1212/wnl.43.1_part_1.183. [DOI] [PubMed] [Google Scholar]
  35. Tsui J. K., Eisen A., Stoessl A. J., Calne S., Calne D. B. Double-blind study of botulinum toxin in spasmodic torticollis. Lancet. 1986 Aug 2;2(8501):245–247. doi: 10.1016/s0140-6736(86)92070-2. [DOI] [PubMed] [Google Scholar]
  36. Whurr R., Lorch M., Fontana H., Brookes G., Lees A., Marsden C. D. The use of botulinum toxin in the treatment of adductor spasmodic dysphonia. J Neurol Neurosurg Psychiatry. 1993 May;56(5):526–530. doi: 10.1136/jnnp.56.5.526. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Yoshimura D. M., Aminoff M. J., Olney R. K. Botulinum toxin therapy for limb dystonias. Neurology. 1992 Mar;42(3 Pt 1):627–630. doi: 10.1212/wnl.42.3.627. [DOI] [PubMed] [Google Scholar]
  38. Zuber M., Sebald M., Bathien N., de Recondo J., Rondot P. Botulinum antibodies in dystonic patients treated with type A botulinum toxin: frequency and significance. Neurology. 1993 Sep;43(9):1715–1718. doi: 10.1212/wnl.43.9.1715. [DOI] [PubMed] [Google Scholar]

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