caa a22 4500 445807636 CHVBK 20180317145201.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00415-010-5880-1 doi (NATIONALLICENCE)springer-10.1007/s00415-010-5880-1 Evolution of dose and response to botulinum toxin A in cervical dystonia: a multicenter study [Elektronische Daten] [Pedro Garcia Ruiz, Juan Martínez Castrillo, Juan Burguera, Victor Campos, Alfonso Castro, Esther Cancho, Jose Chacón, Jaime Hernández Vara, Javier del Val, Elena Lopez Garcia, Francesc Miquel, Pilar Sanz, Lydia Vela] Botulinum neurotoxin (BoNT) is an effective treatment for cervical dystonia (CD). Long-term changes of several variables, including the dose of BoNT, in these patients is largely unknown. We reviewed the clinical charts of 275 patients with CD treated with BoNT type A (BoNT-A) for at least 5years since 1989 at ten tertiary centers. The mean dose of BoNT-A per session during the first 5years of treatment was calculated and the appearance of resistance was noted. The dose of BoNT-A for the whole group showed a significant trend to increase over time (year 1: 180±65U; year 5: 203±63U; ANOVA: p<0.0001). However, when we studied the evolution of the dose of BoNT-A for those patients (n=49) first injected after 2000 (introduction of current BOTOX preparation in our country), there was no significant increase in dose (year 1: 181.8±75U; year 5: 181.7±75U; ANOVA p: ns). A total of 19 patients became secondary nonresponders; all but one of these patients began BoNT-A treatment before 2000. In summary, there is a statistically significant increase of mean dose of BoNT-A per session over time, and this could be explained by the appearance of secondary nonresponders. On the other hand, those patients initially treated after 2000 did not show any statistically significant increase in dose for 5years. This could be explained by better experience and techniques, fewer immunogenic problems with the current BoNT-A, and also less variability of the dose per vial. Springer-Verlag, 2010 Cervical dystonia nationallicence Botulinum toxin nationallicence Garcia Ruiz Pedro Department of Neurology, Fundación Jiménez Díaz, Madrid, Spain aut Martínez Castrillo Juan Department of Neurology, Hospital Ramón y Cajal, 28034, Madrid, Spain aut Burguera Juan Department of Neurology, Hospital Universitario La Fé, Valencia, Spain aut Campos Victor Department of Neurology, Hospital Clinico Universitario, Malaga, Spain aut Castro Alfonso Department of Neurology, Hospital Clínico de Santiago, Santiago de Compostela, Santiago, Spain aut Cancho Esther Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain aut Chacón Jose Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain aut Hernández Vara Jaime Department of Neurology, Hospital Valle de Hebrón, Barcelona, Spain aut del Val Javier Department of Neurology, Hospital Clínico Universitario, Saragossa, Spain aut Lopez Garcia Elena Department of Neurology, Hospital Clínico Universitario, Saragossa, Spain aut Miquel Francesc Department of Neurology, Hospital Valle de Hebrón, Barcelona, Spain aut Sanz Pilar Department of Neurology, Hospital de Mataró, Barcelona, Spain aut Vela Lydia Department of Neurology, Fundación Hospital Alcorcón, Madrid, Spain aut Journal of Neurology Springer-Verlag 258/6(2011-06-01), 1055-1057 0340-5354 258:6<1055 2011 258 415 https://doi.org/10.1007/s00415-010-5880-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-010-5880-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Garcia Ruiz Pedro Department of Neurology, Fundación Jiménez Díaz, Madrid, Spain aut NATIONALLICENCE 700 1- Martínez Castrillo Juan Department of Neurology, Hospital Ramón y Cajal, 28034, Madrid, Spain aut NATIONALLICENCE 700 1- Burguera Juan Department of Neurology, Hospital Universitario La Fé, Valencia, Spain aut NATIONALLICENCE 700 1- Campos Victor Department of Neurology, Hospital Clinico Universitario, Malaga, Spain aut NATIONALLICENCE 700 1- Castro Alfonso Department of Neurology, Hospital Clínico de Santiago, Santiago de Compostela, Santiago, Spain aut NATIONALLICENCE 700 1- Cancho Esther Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain aut NATIONALLICENCE 700 1- Chacón Jose Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain aut NATIONALLICENCE 700 1- Hernández Vara Jaime Department of Neurology, Hospital Valle de Hebrón, Barcelona, Spain aut NATIONALLICENCE 700 1- del Val Javier Department of Neurology, Hospital Clínico Universitario, Saragossa, Spain aut NATIONALLICENCE 700 1- Lopez Garcia Elena Department of Neurology, Hospital Clínico Universitario, Saragossa, Spain aut NATIONALLICENCE 700 1- Miquel Francesc Department of Neurology, Hospital Valle de Hebrón, Barcelona, Spain aut NATIONALLICENCE 700 1- Sanz Pilar Department of Neurology, Hospital de Mataró, Barcelona, Spain aut NATIONALLICENCE 700 1- Vela Lydia Department of Neurology, Fundación Hospital Alcorcón, Madrid, Spain aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/6(2011-06-01), 1055-1057 0340-5354 258:6<1055 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer