oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study
Tahwinder Upile, Behrad Elmiyeh, Waseem Jerjes, Vyas Prasad, Panagiotis Kafas, Jesuloba Abiola, Bryan Youl, Ruth Epstein, Colin Hopper, Holger Sudhoff, John Rubin
Head & Face Medicine , 2009, DOI: 10.1186/1746-160x-5-20
Abstract: Data were gathered prospectively on voice improvement (self-rated 6 point scale), length of response and duration of complications (breathiness, cough, dysphagia and total voice loss). Injections were performed under electromyography (EMG) guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven.Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS) and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections.Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia.Adductor spasmodic dysphonia (ADSD) is a focal dystonia of the laryngeal musculature, causing abrupt, intermittent and involuntary vocal folds spasms producing a strained and strangled speech pattern. It is idiopathic in nature and may reflect abnormalities in central motor processing [1].The cardinal signs of ADSD are effortful vocal straining and harshness, quaver and voice arrest due to laryngospasm in the midst of non-effortful phonatory periods. It is described as "speaking whilst being strangled". Examination of the larynx may reveal true and false vocal folds hyper-adduction with laryngeal elevation and its attendant effects on speech. ADSD, a disabling disorder of voice, is characterised by involuntary disruption of phonation with functional, social and emotional consequences [1].Botulinum toxin is the treatment of choice for ADSD and has been in use since the late 1980's [2-5]. It improves the patients' perception of dysphonia, mental health and their social function [6]. The American Academy of Otolaryngology-Head and Neck Surgery recognizes treatment with Botulinum toxin as t
Botulinum toxin in the management of acquired motor fusion deficiency  [cached]
Murthy Ramesh,Kesarwani Siddharth
Indian Journal of Ophthalmology , 2009,
Abstract: Acquired disruption of motor fusion is a rare condition characterized by intractable diplopia. Management of these patients is extremely difficult. Prisms in any combination or even surgery may not help relieve their symptoms. We describe a longstanding case of acquired motor fusion disruption which was managed successfully with botulinum toxin injection.
Botulinum toxin injections for blepharospasm prior to ocular surgeries
Okumus S, Coskun E, Erbagci , Tatar MG, Comez A, Kaydu E, Yayuspayi R, Gurler B
Clinical Ophthalmology , 2012, DOI: http://dx.doi.org/10.2147/OPTH.S30277
Abstract: otulinum toxin injections for blepharospasm prior to ocular surgeries Original Research (2387) Total Article Views Authors: Okumus S, Coskun E, Erbagci , Tatar MG, Comez A, Kaydu E, Yayuspayi R, Gurler B Published Date May 2012 Volume 2012:6 Pages 579 - 583 DOI: http://dx.doi.org/10.2147/OPTH.S30277 Received: 27 January 2012 Accepted: 12 March 2012 Published: 03 May 2012 Seydi Okumus1, Erol Coskun1, brahim Erbagci1, M Gürkan Tatar2, Aysegul Comez1, Erdal Kaydu1, Ramazan Yayuspayi1, Bulent Gurler1 1Department of Ophthalmology, University of Gaziantep, 2Ophthalmology Clinic, Nizip State Hospital, Nizip, Gaziantep, Turkey Purpose: The aim of this study was to show the efficiency of preoperative botulinum toxin A (Botox A) in patients with benign essential blepharospasm who were to undergo ocular surgery with local anesthesia. Materials and methods: Twenty-eight benign essential blepharospasm patients who were administered unilateral Botox A prior to ocular surgery between January 2004 and May 2011 were included in this study. Eleven cases had pterygiums, ten had cataracts, and four had glaucomas, while the remaining three had aphakia. All cases’ severity of spasm (stage 0–4) and eyelid closing forces (stage 1–4) were evaluated according to the Jankovic scale prior to the injection, at 3 days, 14 days, 1 month, and 3 months after Botox A injection. Results: Of the patients enrolled in the study, 16 were female and 12 were male, with an average age of 55.52 ± 1.53 years (52–65). Average onset of the Botox injection's effect was 2.8 ± 0.9 (2–5) days. Its effect lingered for about 11.5 ± 3.6 (8–22) weeks. The severity of spasm and eyelid closing forces of all the patients enrolled were compared prior to the injection at 3 and 14 days and the first and third months after the injection. There were statistically significant differences between prior to the injection and 3 days (P = 0.001), 14 days (P < 0.001) and 1 month after the injection (P <0.001). There was no statistically significant difference between prior to the injection and 3 months after the injection (P = 0.513). Fourteen days following the injection, the surgeries were successfully performed. Conclusion: Botox A administered prior to ocular surgery will control both blepharospasm and lower the risks that can be encountered before and during surgery, thus increasing the comfort of the patient and the surgeon.
Botulinum toxin injections for blepharospasm prior to ocular surgeries  [cached]
Okumus S,Coskun E,Erbagci ?,Tatar MG
Clinical Ophthalmology , 2012,
Abstract: Seydi Okumus1, Erol Coskun1, brahim Erbagci1, M Gürkan Tatar2, Aysegul Comez1, Erdal Kaydu1, Ramazan Yayuspayi1, Bulent Gurler11Department of Ophthalmology, University of Gaziantep, 2Ophthalmology Clinic, Nizip State Hospital, Nizip, Gaziantep, TurkeyPurpose: The aim of this study was to show the efficiency of preoperative botulinum toxin A (Botox A) in patients with benign essential blepharospasm who were to undergo ocular surgery with local anesthesia.Materials and methods: Twenty-eight benign essential blepharospasm patients who were administered unilateral Botox A prior to ocular surgery between January 2004 and May 2011 were included in this study. Eleven cases had pterygiums, ten had cataracts, and four had glaucomas, while the remaining three had aphakia. All cases’ severity of spasm (stage 0–4) and eyelid closing forces (stage 1–4) were evaluated according to the Jankovic scale prior to the injection, at 3 days, 14 days, 1 month, and 3 months after Botox A injection.Results: Of the patients enrolled in the study, 16 were female and 12 were male, with an average age of 55.52 ± 1.53 years (52–65). Average onset of the Botox injection's effect was 2.8 ± 0.9 (2–5) days. Its effect lingered for about 11.5 ± 3.6 (8–22) weeks. The severity of spasm and eyelid closing forces of all the patients enrolled were compared prior to the injection at 3 and 14 days and the first and third months after the injection. There were statistically significant differences between prior to the injection and 3 days (P = 0.001), 14 days (P < 0.001) and 1 month after the injection (P <0.001). There was no statistically significant difference between prior to the injection and 3 months after the injection (P = 0.513). Fourteen days following the injection, the surgeries were successfully performed.Conclusion: Botox A administered prior to ocular surgery will control both blepharospasm and lower the risks that can be encountered before and during surgery, thus increasing the comfort of the patient and the surgeon.Keywords: botulinum toxin A, blepharospasm, ocular surgery
Long-Term Efficacy and Safety of Botulinum Toxin Injections in Dystonia  [PDF]
Juan Ramirez-Castaneda,Joseph Jankovic
Toxins , 2013, DOI: 10.3390/toxins5020249
Abstract: Local chemodenervation with botulinum toxin (BoNT) injections to relax abnormally contracting muscles has been shown to be an effective and well-tolerated treatment in a variety of movement disorders and other neurological and non-neurological disorders. Despite almost 30 years of therapeutic use, there are only few studies of patients treated with BoNT injections over long period of time. These published data clearly support the conclusion that BoNT not only provides safe and effective symptomatic relief of dystonia but also long-term benefit and possibly even favorably modifying the natural history of this disease. The adverse events associated with chronic, periodic exposure to BoNT injections are generally minor and self-limiting. With the chronic use of BoNT and an expanding list of therapeutic indications, there is a need to carefully examine the existing data on the long-term efficacy and safety of BoNT. In this review we will highlight some of the aspects of long-term effects of BoNT, including efficacy, safety, and immunogenicity.
Tetanus: Pathophysiology, Treatment, and the Possibility of Using Botulinum Toxin against Tetanus-Induced Rigidity and Spasms  [PDF]
Bj?rnar Hassel
Toxins , 2013, DOI: 10.3390/toxins5010073
Abstract: Tetanus toxin, the product of Clostridium tetani, is the cause of tetanus symptoms. Tetanus toxin is taken up into terminals of lower motor neurons and transported axonally to the spinal cord and/or brainstem. Here the toxin moves trans-synaptically into inhibitory nerve terminals, where vesicular release of inhibitory neurotransmitters becomes blocked, leading to disinhibition of lower motor neurons. Muscle rigidity and spasms ensue, often manifesting as trismus/lockjaw, dysphagia, opistotonus, or rigidity and spasms of respiratory, laryngeal, and abdominal muscles, which may cause respiratory failure. Botulinum toxin, in contrast, largely remains in lower motor neuron terminals, inhibiting acetylcholine release and muscle activity. Therefore, botulinum toxin may reduce tetanus symptoms. Trismus may be treated with botulinum toxin injections into the masseter and temporalis muscles. This should probably be done early in the course of tetanus to reduce the risk of pulmonary aspiration, involuntary tongue biting, anorexia and dental caries. Other muscle groups are also amenable to botulinum toxin treatment. Six tetanus patients have been successfully treated with botulinum toxin A. This review discusses the use of botulinum toxin for tetanus in the context of the pathophysiology, symptomatology, and medical treatment of Clostridium tetani infection.
Effect of a clown’s presence at botulinum toxin injections in children: a randomized, prospective study  [cached]
Hansen LK,Kibaek M,Martinussen T,Kragh L
Journal of Pain Research , 2011,
Abstract: Lars Kjaersgaard Hansen1, Maria Kibaek1, Torben Martinussen2, Lene Kragh3, Mogens Hejl11Department of Paediatrics, Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense; 2Roskilde Hospital, Roskilde; 3Department of Statistics, University of Southern Denmark, Odense, DenmarkBackground: The effect of the presence of a hospital clown during pediatric procedures has rarely been evaluated. In a pediatric ward, botulinum toxin injection is a painful procedure and a stressful experience for the child. We undertook a study of the effect of the presence of a hospital clown on children treated with botulinum toxin in an outpatient setting.Methods: In total, 60 children, the majority of whom had spastic cerebral palsy, were subjected to a total of 121 botulinum toxin treatment sessions. Thirty-two children were being treated for the first time. During a 2-year period, we enrolled 121 treatment sessions prospectively, and the children were randomized to either the presence of a female clown during treatment or to no presence of a clown. The duration of the child's crying during the procedure was used as an indicator of the effect of the presence of a clown.Results: The effect of the clown was significantly related to patient gender. Girls were found to have a significantly shorter period of crying when the clown was present. For children younger than 8 years, the effect on boys was negative. Children treated for the first time did not appear to benefit from the presence of the clown, and showed no difference in effect between genders.Conclusion: No effect of the clown was documented for children being treated for the first time. At repeat treatments, we saw a positive effect of the female clown in relation to girls, and a negative effect on boys younger than 8 years of age.Keywords: clown, injections, pain, botulinum toxin
Botulinum toxin in the treatment of sialorrhea  [PDF]
Svetel Marina,Vasi? Milan,Draga?evi? Nata?a,Pekmezovi? Tatjana
Vojnosanitetski Pregled , 2009, DOI: 10.2298/vsp0901009s
Abstract: Background/Aim. Botulinum toxin-A (BTX-A) is known to block the release of acetylcholine from motor and autonomic nerve terminals and may significantly decrease saliva production when injected intraglandulary. The aim of this study was to evaluate effects of BTX-A injections in the treatment of disabling sialorrhea in various neurological disorders. Methods. This study included 19 consecutive patients with significant sialorrhea associated with various neurological disorders. Out of them 13 patients were with Parkinson's disease, two with pantothenate kinase-associated neurodegeneration, two with multiple system atrophy, one with Wilson's disease, and one patient with postoperative sialorrhea. Botulinum toxin-A (Dysport , Ipsen Pharma) was injected into the parotid glands with (n = 7 patients) or without (n = 12 patients) ultrasound guidance. All the patients were scored before and after the treatment and in weekly intervals thereafter using the salivation item of the part II (Activities of Daily Living) of the Unified Parkinson's Disease Rating Scale (UPDRS). Results. Thirteen patients (68%) reported beneficial effect of BTX-A injection, while 6 of them (32%) had no response at all. The sialorrhea scores before and after the treatment were 3.1 ± 0.1 (range 2-4) and 1.8 ± 0.1 (range 0- 3), respectively (t = 5.636; p < 0.001). There was no difference in the magnitude of response between the groups with (t = 4.500; p = 0.004) and without (t = 3.674; p = 0.005) ultrasound control of injection sites. Adverse effects were registered in 5 patients (26%). Conclusions. Botulinum toxin-A injections to easily accessible parotid glands, without necessity for ultrasound guidance, are safe and efficaceous treatment for sialorrhea in different neurological disorders.
Influence of Botulinum Toxin Therapy on Postural Control and Lower Limb Intersegmental Coordination in Children with Spastic Cerebral Palsy  [PDF]
Marc Degelaen,Ludo de Borre,Eric Kerckhofs,Linda de Meirleir,Ronald Buyl,Guy Cheron,Bernard Dan
Toxins , 2013, DOI: 10.3390/toxins5010093
Abstract: Botulinum toxin injections may significantly improve lower limb kinematics in gait of children with spastic forms of cerebral palsy. Here we aimed to analyze the effect of lower limb botulinum toxin injections on trunk postural control and lower limb intralimb (intersegmental) coordination in children with spastic diplegia or spastic hemiplegia (GMFCS I or II). We recorded tridimensional trunk kinematics and thigh, shank and foot elevation angles in fourteen 3–12 year-old children with spastic diplegia and 14 with spastic hemiplegia while walking either barefoot or with ankle-foot orthoses (AFO) before and after botulinum toxin infiltration according to a management protocol. We found significantly greater trunk excursions in the transverse plane (barefoot condition) and in the frontal plane (AFO condition). Intralimb coordination showed significant differences only in the barefoot condition, suggesting that reducing the degrees of freedom may limit the emergence of selective coordination. Minimal relative phase analysis showed differences between the groups (diplegia and hemiplegia) but there were no significant alterations unless the children wore AFO. We conclude that botulinum toxin injection in lower limb spastic muscles leads to changes in motor planning, including through interference with trunk stability, but a combination of therapies (orthoses and physical therapy) is needed in order to learn new motor strategies.
Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series
Anil Bhave, Michael G Zywiel, Slif D Ulrich, Mike S McGrath, Thorsten M Seyler, David R Marker, Ronald E Delanois, Michael A Mont
Journal of Orthopaedic Surgery and Research , 2009, DOI: 10.1186/1749-799x-4-34
Abstract: Ten patients (14 hips) who had hip adductor, abductor, and/or flexor muscle contractures following total arthroplasty and had been refractory to physical therapeutic efforts were treated with injection of botulinum toxin A. Eight limbs received injections into the adductor muscle, 8 limbs received injections into the tensor fascia lata muscle, and 2 limbs received injection into the rectus femoris muscle, followed by intensive physical therapy for 6 weeks.At a mean final follow-up of 20 months, all 14 hips had increased range in the affected arc of motion, with a mean improvement of 23 degrees (range, 10 to 45 degrees). Additionally all hips had an improvement in hip scores, with a significant increase in mean score from 74 points (range, 57 to 91 points) prior to injection to a mean of 96 points (range, 93 to 98) at final follow-up. There were no serious treatment-related adverse events.Botulinum toxin A injections combined with intensive physical therapy may be considered as a potential treatment modality, especially in difficult cases of muscle tightness that are refractory to standard therapy.Adductor and tensor fascia lata muscle contractures following total hip arthroplasty are problems that can compromise results. Although certain underlying neuromuscular conditions such as Parkinson's disease may increase the risk of post-operative muscle tightness [1], the reason for contracture development is unclear in many patients. There have been recent attempts using various surgical techniques, including modified and minimally invasive approaches aimed at reducing this complication. In addition, various rehabilitation algorithms have been utilized in combination with these surgical techniques to attempt to further reduce the incidence and severity of these functional contractures [2-4]. Despite the reduction in their overall frequency, persistent contractures remain difficult to treat in some patients and may require further operative intervention. Some of the common
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.