Botulinum Toxin Application Experiences in Adıyaman University, Department of Neurology: A Retrospective Study
Öz
Aim: The most known potent accepted as biological
toxin is Clostridium botulinum. Botulinum toxin type A (BoNT-A) in the
neuromuscular junction leads to loose paralysis by inhibiting
acetylcholine release from presynaptic nerve ending and muscle
cholinergic transmission. For this effect, application areas in some
neurological diseases of the toxin have been shaped as hemifacial spasm,
essential blepharospasm, cervical dystonia, task-specific dystonia and
spasticity in adult post-stroke.
Material and Method: In this
retrospective study, between January 2015 – May 2016, of the 21 patients
monitored in our clinic and whose BoNT-A injections are applied to, the
diagnosis and treatment schemes, the responses to botulinum toxin
treatment, common side effects encountered in therapy, the patients’
follow-up done during the treatment and the response to the treatment
subjectively evaluated by patients have been reported and discussed.
Results:
The improvement in patients’ response to treatment was subjective by
themselves as a good recovery of 50% or better and poor recovery of less
than 50% by themselves.
Conclusion: Positive results were obtained in the indications of BoNT-A application in the study.
Anahtar Kelimeler
botulinum toxin hemifacial spasm blepharospasm; cervical dystonia; spasticity
Kaynakça
- 1. Jankovic J, Albanese A, Atassi MZ, Dolly JO, Hallet M, Mayer N. Botulinum toxin: Therapeutic Clin Pract Sci. New York: Saunders; 2008.
- 2. Turton K, Chaddock JA, Acharya KR. Botulinum and tetanus neurotoxins: structure, function and therapeutic utility. Trends in Biochem Sci 2002;27:552–8.
- 3. Simpson LL. The origin, structure, and pharmacological activity of botulinum toxin. Pharmacol Rev 1981;33(3):155–88.
- 4. Rossetto O, Seveso M, Caccin P, Schiavo G, Montecucco C. Tetanus and botulinum neurotoxins: turning bad guys into good by research. Toxicon 2001;39(1):27–41.
- 5. Akdemir MO, Uğurbaş SC, Uğurbaş SH. Benign Esansiyel Blefarospazm ve Hemifasiyal Spazm Tedavisinde Botulinum Toksin Uygulamasının Uzun Dönem Etkisi. Turk J Ophthalmol 2015;45:9–13.
- 6. Berardelli A, Formica A, Mercuri B, Abbruzzese G, Agnoli A, Agostino R, et al. 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;14:361–7.
- 7. Evidente VG, Adler CH. Hemifacial spasm and other craniofacial movement disorders. Mayo Clin Proc 1998;73:67–71.
- 8. Cardoso F, Jankovic J. Blepharospasm. Handbook of dystonia. Marcel Dekker, 1995;129–41.
- 9. Ramirez-Castaneda J, Jankovic J. Long-term efficacy and safety of botulinum toxin injections in dystonia. Toxins (Basel)2013;5(2):249–66.
- 10. Baizabal-Carvallo JF, Jankovic J, Pappert E. Flu-like symptoms following botulinum toxin therapy. Toxicon 2011;58(1):1–7.
- 11. Moore AP. Movement, visceral and autonomic disorders: use of botulinum toxin. Hospital Med 2003;64:452–9.
- 12. Blitzer A, Sulica L. Botulinum toxin: Basic science and clinical uses in otolaryngolog y. Laryngoscope 2001;111:218–26.
- 13. Cakmur R, Ozturk V, Uzunel F, Donmez B, Idiman F. Comparison Of Preseptal And Pretarsal Injections Of Botulinum Toxin In The Treatment Of Blepharospasm And Hemifacial Spasm. J Neurol 2002;249:64–8.
- 14. Albanese A, Bentivoglio AR, Colosimo C, Galardi G, Maderna L, Tonali P. Pretarsal injections of botulinum toxin improve blepharospazm in previously unresponsive patients. J Neurol Neurosurg Psychiatry 1996;61:693–4.
- 15. Aramideh M, Visser BWO, Brans JWM, Koelman JH, Speelman JD. Pretarsal application ofbotulinum toxin for treatment of blepharospazm. J Neurol Neurosurg Psychiatry 1995;59:309–11.
- 16. Cakmur R. Blefarospazm ve Hemifasiyal Spazmda Botulinum Toksini Tedavisi Nöropsikiyatri Arşivi 2010;47 Özel Sayı:6–10.
- 17. Türker H, Onar M, Demir O, Tunalı G. Ondokuz Mayıs Üniversitesi Nöroloji Kliniğinde Botulinum Toksin Uygulamaları: Retrospektif Bir Çalışma. O. M. Ü. Tıp Derg 2007;24(1):6–14.
- 18. Kwan MC, Ko KF, Chan TP, Chan YW. Treatment of dystonia with botulinum A toxin: a retrospective study of 170 patients. HKMJ 1998;4:279–82.
- 19. Park YC, Lim JK, Lee DK, Yi SD. Botulinum: A toxin treatment of hemifacial spasm and blepharospasm. J Korean Med Sci 1993;8:334–40.
- 20. Jankovic J, Vuong KD, Ahsan J. Comparison of efficacy and immunogenecity of original versus current botulinum toxin in cervical dystonia. Neurol 2003;60:1186–8.
- 21. Karataş GK, Meray J, Sepici V. Üst ekstremite spastisitesinin tedavisinde botulinum A toksini. İç Hast Derg 2000;7(4):181–5.
- 22. Durtton JJ. Botulinum-A toxin in the treatment of craniocervical muscle spasm: short and long term, local and systemic effects. Surv Ophtalmol 1999;41:51–65.
- 23. Anderson TJ, Rivest J, Stell R, Steiger MJ, Cohen H, Thompson PD, et al. Botulinum toxin treatment of spasmodic torticollis. J Royal Soc Med 1992;85:524–9.
- 24. Matur Z, Gülşen Parman Y. Spastisite Tedavisinde A Tipi Botulinum Toksini Kullanımı. Nöropsikiyatri Arşivi 2010;47:40–3.
- 25. Naumann M, Boo LM, Ackerman AH, Gallagher CJ. Immunogenicity of botulinum toxins. J Neural Transm 2013;120(2):275–90.
- 26. Tüfekçi A. Botulinum toksini uygulamalarında olası yan etkiler ve takipleri. Turkiye Klinikleri J Neurol-Special Topics 2013;6(4):46–51.
Öz
Amaç: Bilinen en potent biyolojik toksin olarak
kabul edilen clostridium botulinum toksinidir. Botulinum toksin tip A
(BoNT-A) nöromüsküler bileşkede presinaptik sinir ucundan asetilkolin
salınımı ve kolinerjik iletimi inhibe ederek kasta gevşek paraliziye yol
açmaktadır. Bu etkisinden dolayı toksinin bazı nörolojik
hastalıklardaki uygulama alanları; hemifasiyal spazm, esansiyel
blefarospazm, servikal distoni, task spesifik distoni ve erişkinde inme
sonrası gelişen spastisite şeklinde olmuştur.
Materyal ve Metot:
Araştırma Ocak 2015 – Mayıs 2016 tarihleri arasında nöroloji kliniğinde
izlenen ve BoNT-A enjeksiyonları uygulanan 21 hastanın tanıları, tedavi
şemaları, botulinum toksin tedavisine yanıtları, tedavide karşılaşılan
yan etkiler ile hastaların tedavileri boyunca yapılan izlemleri ve
tedaviye yanıtın hastalar tarafından subjektif değerlendirmeleri rapor
edilmiş ve tartışılmıştır.
Bulgular: Hastaların tedaviye
yanıtlarındaki düzelme kendileri tarafından subjektif olarak %50 ve
üzerindeki düzelmeyi iyi olarak ve %50’nin altındaki düzelmeyi ise kötü
olarak ifade etmişlerdir.
Sonuç: Araştırmada BoNT-A uygulamasının endikasyonlarında olumlu sonuçlar alınmıştır.
Anahtar Kelimeler
botulinum toksini hemifasiyal spazm blefarospazm; servikal distoni; spastisite
Kaynakça
- 1. Jankovic J, Albanese A, Atassi MZ, Dolly JO, Hallet M, Mayer N. Botulinum toxin: Therapeutic Clin Pract Sci. New York: Saunders; 2008.
- 2. Turton K, Chaddock JA, Acharya KR. Botulinum and tetanus neurotoxins: structure, function and therapeutic utility. Trends in Biochem Sci 2002;27:552–8.
- 3. Simpson LL. The origin, structure, and pharmacological activity of botulinum toxin. Pharmacol Rev 1981;33(3):155–88.
- 4. Rossetto O, Seveso M, Caccin P, Schiavo G, Montecucco C. Tetanus and botulinum neurotoxins: turning bad guys into good by research. Toxicon 2001;39(1):27–41.
- 5. Akdemir MO, Uğurbaş SC, Uğurbaş SH. Benign Esansiyel Blefarospazm ve Hemifasiyal Spazm Tedavisinde Botulinum Toksin Uygulamasının Uzun Dönem Etkisi. Turk J Ophthalmol 2015;45:9–13.
- 6. Berardelli A, Formica A, Mercuri B, Abbruzzese G, Agnoli A, Agostino R, et al. 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;14:361–7.
- 7. Evidente VG, Adler CH. Hemifacial spasm and other craniofacial movement disorders. Mayo Clin Proc 1998;73:67–71.
- 8. Cardoso F, Jankovic J. Blepharospasm. Handbook of dystonia. Marcel Dekker, 1995;129–41.
- 9. Ramirez-Castaneda J, Jankovic J. Long-term efficacy and safety of botulinum toxin injections in dystonia. Toxins (Basel)2013;5(2):249–66.
- 10. Baizabal-Carvallo JF, Jankovic J, Pappert E. Flu-like symptoms following botulinum toxin therapy. Toxicon 2011;58(1):1–7.
- 11. Moore AP. Movement, visceral and autonomic disorders: use of botulinum toxin. Hospital Med 2003;64:452–9.
- 12. Blitzer A, Sulica L. Botulinum toxin: Basic science and clinical uses in otolaryngolog y. Laryngoscope 2001;111:218–26.
- 13. Cakmur R, Ozturk V, Uzunel F, Donmez B, Idiman F. Comparison Of Preseptal And Pretarsal Injections Of Botulinum Toxin In The Treatment Of Blepharospasm And Hemifacial Spasm. J Neurol 2002;249:64–8.
- 14. Albanese A, Bentivoglio AR, Colosimo C, Galardi G, Maderna L, Tonali P. Pretarsal injections of botulinum toxin improve blepharospazm in previously unresponsive patients. J Neurol Neurosurg Psychiatry 1996;61:693–4.
- 15. Aramideh M, Visser BWO, Brans JWM, Koelman JH, Speelman JD. Pretarsal application ofbotulinum toxin for treatment of blepharospazm. J Neurol Neurosurg Psychiatry 1995;59:309–11.
- 16. Cakmur R. Blefarospazm ve Hemifasiyal Spazmda Botulinum Toksini Tedavisi Nöropsikiyatri Arşivi 2010;47 Özel Sayı:6–10.
- 17. Türker H, Onar M, Demir O, Tunalı G. Ondokuz Mayıs Üniversitesi Nöroloji Kliniğinde Botulinum Toksin Uygulamaları: Retrospektif Bir Çalışma. O. M. Ü. Tıp Derg 2007;24(1):6–14.
- 18. Kwan MC, Ko KF, Chan TP, Chan YW. Treatment of dystonia with botulinum A toxin: a retrospective study of 170 patients. HKMJ 1998;4:279–82.
- 19. Park YC, Lim JK, Lee DK, Yi SD. Botulinum: A toxin treatment of hemifacial spasm and blepharospasm. J Korean Med Sci 1993;8:334–40.
- 20. Jankovic J, Vuong KD, Ahsan J. Comparison of efficacy and immunogenecity of original versus current botulinum toxin in cervical dystonia. Neurol 2003;60:1186–8.
- 21. Karataş GK, Meray J, Sepici V. Üst ekstremite spastisitesinin tedavisinde botulinum A toksini. İç Hast Derg 2000;7(4):181–5.
- 22. Durtton JJ. Botulinum-A toxin in the treatment of craniocervical muscle spasm: short and long term, local and systemic effects. Surv Ophtalmol 1999;41:51–65.
- 23. Anderson TJ, Rivest J, Stell R, Steiger MJ, Cohen H, Thompson PD, et al. Botulinum toxin treatment of spasmodic torticollis. J Royal Soc Med 1992;85:524–9.
- 24. Matur Z, Gülşen Parman Y. Spastisite Tedavisinde A Tipi Botulinum Toksini Kullanımı. Nöropsikiyatri Arşivi 2010;47:40–3.
- 25. Naumann M, Boo LM, Ackerman AH, Gallagher CJ. Immunogenicity of botulinum toxins. J Neural Transm 2013;120(2):275–90.
- 26. Tüfekçi A. Botulinum toksini uygulamalarında olası yan etkiler ve takipleri. Turkiye Klinikleri J Neurol-Special Topics 2013;6(4):46–51.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Ağustos 2017 |
| Yayımlandığı Sayı | Yıl 2017 Yıl: 2017 Sayı: 2 |