Download PDF
Semin Neurol 2016; 36(01): 041-046
DOI: 10.1055/s-0035-1571211
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Update on the Use of Botulinum Toxin Therapy for Focal and Task-Specific Dystonias

Codrin Lungu
1   Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
,
Omar F. Ahmad
1   Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
› Author Affiliations
Further Information

Publication History

Publication Date:
11 February 2016 (online)

    Permissions and Reprints

Abstract

Focal dystonia is defined by anatomical distribution and represents a distinct entity from generalized dystonia. Task-specific dystonia occurs in the context of specific patterns of movement. Botulinum neurotoxin (BoNT) injections are the treatment of choice in most cases. Several formulations are available; the approved indications, dosing, and some administration details, differ between them. The major forms of focal and task-specific dystonia are reviewed, along with the evidence for BoNT therapy, the expected benefit and side effects, and practical points guiding the injections.

Keywords

botulinum - dystonia - therapy - task-specific - focal dystonia
 

  • References

  • 1 Albanese A, Bhatia K, Bressman SB , et al. Phenomenology and classification of dystonia: a consensus update. Mov Disord 2013; 28 (7) 863-873
    CrossrefPubMedSearch in Google Scholar
  • 2 Torres-Russotto D, Perlmutter JS. Task-specific dystonias: a review. Ann N Y Acad Sci 2008; 1142: 179-199
    CrossrefPubMedSearch in Google Scholar
  • 3 Ramdhani RA, Kumar V, Velickovic M, Frucht SJ, Tagliati M, Simonyan K. What's special about task in dystonia? A voxel-based morphometry and diffusion weighted imaging study. Mov Disord 2014; 29 (9) 1141-1150
    CrossrefPubMedSearch in Google Scholar
  • 4 Albanese A, Asmus F, Bhatia KP , et al. EFNS guidelines on diagnosis and treatment of primary dystonias. Eur J Neurol 2011; 18 (1) 5-18
    CrossrefPubMedSearch in Google Scholar
  • 5 Simpson DM, Blitzer A, Brashear A , et al; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008; 70 (19) 1699-1706
    CrossrefPubMedSearch in Google Scholar
  • 6 Sheehy MP, Marsden CD. Writers' cramp-a focal dystonia. Brain 1982; 105 (Pt 3) 461-480
    CrossrefPubMedSearch in Google Scholar
  • 7 Hunter D. The Diseases of Occupations. 6th ed. London: Hodder and Stoughton; 1978
    Search in Google Scholar
  • 8 Karp BI. Limb dystonia. In: Stacey MA, , ed. Handbook of Dystonia. Boca Raton, FL: CRC Press; 2007: 155-177
    Search in Google Scholar
  • 9 Chen R, Hallett M. Focal dystonia and repetitive motion disorders. Clin Orthop Relat Res 1998; (351) 102-106
    PubMedSearch in Google Scholar
  • 10 Rothwell JC, Traub MM, Marsden CD. Primary writing tremor. J Neurol Neurosurg Psychiatry 1979; 42 (12) 1106-1114
    CrossrefPubMedSearch in Google Scholar
  • 11 Ravits J, Hallett M, Baker M, Wilkins D. Primary writing tremor and myoclonic writer's cramp. Neurology 1985; 35 (9) 1387-1391
    CrossrefPubMedSearch in Google Scholar
  • 12 Merello M, Carpintiero S, Cammarota A, Meli F, Leiguarda R. Bilateral mirror writing movements (mirror dystonia) in a patient with writer's cramp: functional correlates. Mov Disord 2006; 21 (5) 683-689
    CrossrefPubMedSearch in Google Scholar
  • 13 Conti AM, Pullman S, Frucht SJ. The hand that has forgotten its cunning—lessons from musicians' hand dystonia. Mov Disord 2008; 23 (10) 1398-1406
    CrossrefPubMedSearch in Google Scholar
  • 14 Norris R. The musician's survival manual: a guide to preventing and treating injuries in instrumentalists. St. Louis, MO: MMB Music; 1993
    Search in Google Scholar
  • 15 Altenmuller E, Ioannou CI, Raab M, Lobinger B. Apollo's curse: causes and cures of motor failures in musicians: a proposal for a new classification. In: Levin MF, , ed. Progress in Motor Control, Advances in Experimental Medicine and Biology. New York: Springer Science + Business Media; 2014: 161-178
    Search in Google Scholar
  • 16 Tubiana R. Musician's focal dystonia. Hand Clin 2003; 19 (2) 303-308 , vii
    CrossrefPubMedSearch in Google Scholar
  • 17 Karp BI. Botulinum toxin treatment of occupational and focal hand dystonia. Mov Disord 2004; 19 (Suppl. 08) S116-S119
    CrossrefPubMedSearch in Google Scholar
  • 18 Cox BC, Cincotta M, Espay AJ. Mirror movements in movement disorders: a review. Tremor Other Hyperkinet Mov (N Y) 2012; 2
    PubMedSearch in Google Scholar
  • 19 Peterson DA, Berque P, Jabusch HC, Altenmüller E, Frucht SJ. Rating scales for musician's dystonia: the state of the art. Neurology 2013; 81 (6) 589-598
    CrossrefPubMedSearch in Google Scholar
  • 20 Lungu C, Karp BI, Alter K, Zolbrod R, Hallett M. Long-term follow-up of botulinum toxin therapy for focal hand dystonia: outcome at 10 years or more. Mov Disord 2011; 26 (4) 750-753
    CrossrefPubMedSearch in Google Scholar
  • 21 Schuele S, Jabusch HC, Lederman RJ, Altenmüller E. Botulinum toxin injections in the treatment of musician's dystonia. Neurology 2005; 64 (2) 341-343
    CrossrefPubMedSearch in Google Scholar
  • 22 Hallett M, Albanese A, Dressler D , et al. Evidence-based review and assessment of botulinum neurotoxin for the treatment of movement disorders. Toxicon 2013; 67: 94-114
    CrossrefPubMedSearch in Google Scholar
  • 23 Mejia NI, Vuong KD, Jankovic J. Long-term botulinum toxin efficacy, safety, and immunogenicity. Mov Disord 2005; 20 (5) 592-597
    CrossrefPubMedSearch in Google Scholar
  • 24 Alter K, Simpson D, Elovic E. Botulinum neurotoxin for the treatment of idiopathic primary limb dystonia. In: Alter K, Wilson N, , eds. Botulinum Neurotoxin Injection Manual. New York: Demos Medical; 2015: 97-120
    Search in Google Scholar
  • 25 Gracies JM, Lugassy M, Weisz DJ, Vecchio M, Flanagan S, Simpson DM. Botulinum toxin dilution and endplate targeting in spasticity: a double-blind controlled study. Arch Phys Med Rehabil 2009; 90 (1) 9-16.e2
    CrossrefPubMedSearch in Google Scholar
  • 26 Alter K, Lungu C. Botulinum Neurotoxin for the Treatment of Trunk Dystonia/Camptocormia. In: Alter K, Wilson N, , eds. Botulinum Neurotoxin Injection Manual. New York: Demos Medical; 2015: 178-187
    Search in Google Scholar
  • 27 Doménech J, Tormos JM, Barrios C, Pascual-Leone A. Motor cortical hyperexcitability in idiopathic scoliosis: could focal dystonia be a subclinical etiological factor?. Eur Spine J 2010; 19 (2) 223-230
    CrossrefPubMedSearch in Google Scholar
  • 28 Bonanni L, Thomas A, Varanese S, Scorrano V, Onofrj M. Botulinum toxin treatment of lateral axial dystonia in Parkinsonism. Mov Disord 2007; 22 (14) 2097-2103
    CrossrefPubMedSearch in Google Scholar
  • 29 Jankovic J. Disease-oriented approach to botulinum toxin use. Toxicon 2009; 54 (5) 614-623
    CrossrefPubMedSearch in Google Scholar
  • 30 Singer C, Papapetropoulos S. Adult-onset primary focal foot dystonia. Parkinsonism Relat Disord 2006; 12 (1) 57-60
    CrossrefPubMedSearch in Google Scholar
  • 31 Wu LJ, Jankovic J. Runner's dystonia. J Neurol Sci 2006; 251 (1–2) 73-76
    CrossrefPubMedSearch in Google Scholar
  • 32 Katz M, Byl NN, San Luciano M, Ostrem JL. Focal task-specific lower extremity dystonia associated with intense repetitive exercise: a case series. Parkinsonism Relat Disord 2013; 19 (11) 1033-1038
    CrossrefPubMedSearch in Google Scholar
  • 33 Pullman SL, Greene P, Fahn S, Pedersen SF. Approach to the treatment of limb disorders with botulinum toxin A. Experience with 187 patients. Arch Neurol 1996; 53 (7) 617-624
    CrossrefPubMedSearch in Google Scholar
  • 34 Sussman J. Musician's dystonia. Pract Neurol 2015; 15 (4) 317-322
    CrossrefPubMedSearch in Google Scholar
  • 35 Halstead LA, McBroom DM, Bonilha HS. Task-specific singing dystonia: vocal instability that technique cannot fix. J Voice 2015; 29 (1) 71-78
    CrossrefPubMedSearch in Google Scholar
  • 36 Blitzer A. Spasmodic dysphonia and botulinum toxin: experience from the largest treatment series. Eur J Neurol 2010; 17 (Suppl. 01) 28-30
    CrossrefPubMedSearch in Google Scholar
  • 37 Cannito MP, Johnson JP. Spastic dysphonia: a continuum disorder. J Commun Disord 1981; 14 (3) 215-233
    CrossrefPubMedSearch in Google Scholar
  • 38 Chitkara A, Meyer T, Keidar A, Blitzer A. Singer's dystonia: first report of a variant of spasmodic dysphonia. Ann Otol Rhinol Laryngol 2006; 115 (2) 89-92
    CrossrefPubMedSearch in Google Scholar
  • 39 Frucht SJ. Embouchure dystonia—Portrait of a task-specific cranial dystonia. Mov Disord 2009; 24 (12) 1752-1762
    CrossrefPubMedSearch in Google Scholar
  • 40 Adler CH, Crews D, Kahol K , et al. Are the yips a task-specific dystonia or “golfer's cramp”?. Mov Disord 2011; 26 (11) 1993-1996
    CrossrefPubMedSearch in Google Scholar
  • 41 McDaniel KD, Cummings JL, Shain S. The “yips”: a focal dystonia of golfers. Neurology 1989; 39 (2 Pt 1) 192-195
    CrossrefPubMedSearch in Google Scholar
  • 42 Sitburana O, Ondo WG. Task-specific focal hand dystonia in a professional pistol-shooter. Clin Neurol Neurosurg 2008; 110 (4) 423-424
    CrossrefPubMedSearch in Google Scholar
  • 43 Bawden M, Maynard I. Towards an understanding of the personal experience of the ‘yips’ in cricketers. J Sports Sci 2001; 19 (12) 937-953
    CrossrefPubMedSearch in Google Scholar
  • 44 Adler CH, Crews D, Hentz JG, Smith AM, Caviness JN. Abnormal co-contraction in yips-affected but not unaffected golfers: evidence for focal dystonia. Neurology 2005; 64 (10) 1813-1814
    CrossrefPubMedSearch in Google Scholar
  • 45 Smith AM, Adler CH, Crews D , et al. The ‘yips’ in golf: a continuum between a focal dystonia and choking. Sports Med 2003; 33 (1) 13-31
    CrossrefPubMedSearch in Google Scholar
  • 46 Dhungana S, Jankovic J. Yips and other movement disorders in golfers. Mov Disord 2013; 28 (5) 576-581
    CrossrefPubMedSearch in Google Scholar