A prospective open study of
botulinum toxin A treatment for patients with various
movement disorders at Siriraj Hospital, Mahidol University was analysed to evaluate its efficacy. The grand total
of 900 patients comprised of a) 592 patients (65.78 per cent) with
hemifacial spasm; b) 92 patients (10.22 per cent) with
occupational cramp;
c) 79 patients (8.78 per cent) with
blepharospasm and
Meige syndrome; d) 72 patients (8.00 per cent) with
spasmodic torticollis; e) 19 patients (2.11 per cent) with hemidystonia and generalised
dystonia; f) 11 patients (1.22 per cent) with spasmodic
dysphonia; g) 10 patients (1.11 per cent) with
spastic hemiparesis; and
h) 25 patients (2.78 per cent) with miscellaneous group (i.e.
tics, Gilles de la Tourette, facial myokimia,
benign fasciculation, etc.). The results of treatment for
hemifacial spasm were classified as excellent in 486 patients (82.09 per cent), moderate improvement in 60 patients (10.14 per cent), mild improvement in 39 patients (6.59 per cent) and no improvement or worse in 7 patients (1.18 per cent). There were complications of mild transient facial weakness in 50 patients (8.45 per cent) and mild ptosis in 12 patients (2.02 per cent). The effect of
botulinum toxin treatment lasted 3-6 months. In
occupational cramp and
spasmodic torticollis the good response rate was around two-thirds of all patients, whereas, blephalospasm, spasmodic
dysphonia, spastic hemiparesis and
tics responsed in 79-88 per cent of the patients.
Botulinum toxin A injection is thus a simple, safe, and effective out-patient treatment for patients with various kinds of
movement disorders but it is a costly
therapy.