The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia
Background: The response to BoNT is not uniform; a broad spectrum of responses and side-effects usually occurs. This study aimed to show special cervical dystonia cases with therapy response very different to normal treatment course which indicate the extreme ends of therapy spectrum. Patients: Clin...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-12-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/13/1/22 |
| _version_ | 1827698710058893312 |
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| author | Sara Samadzadeh Raphaela Brauns Harald Hefter |
| author_facet | Sara Samadzadeh Raphaela Brauns Harald Hefter |
| author_sort | Sara Samadzadeh |
| collection | DOAJ |
| description | Background: The response to BoNT is not uniform; a broad spectrum of responses and side-effects usually occurs. This study aimed to show special cervical dystonia cases with therapy response very different to normal treatment course which indicate the extreme ends of therapy spectrum. Patients: Clinical data and course of treatment of five long-term treated patients with cervical dystonia out of therapy response norms are presented: a patient who was supersensitive to standard dose and has required dose adjustment to lower dose of BoNT; one patient who worsened under a standard dose, but responded excellently to twice the standard dose; one insensitive patient who responded poorly for years to a dose well above the standard dose, but responded when dose was further increased; and two patients with a totally different response pattern to BoNT/A preparation 1, but the development of a neutralizing antibody induced secondary treatment failure in both cases and a totally different response after switch to BoNT/A preparation 2. Conclusions: These five patients indicate that the response of a patient to a BoNT preparation may be unexpected. Therefore, cautious onset of BoNT therapy is recommended as well as consequent dose adjustment later on and even switch to another BoNT/A preparation when a patient has already developed NABs against BoNT/A. |
| first_indexed | 2024-03-10T13:34:57Z |
| format | Article |
| id | doaj.art-8886aefa7d094555b85b5d052a6b3802 |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-10T13:34:57Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-8886aefa7d094555b85b5d052a6b38022023-11-21T07:38:06ZengMDPI AGToxins2072-66512020-12-011312210.3390/toxins13010022The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical DystoniaSara Samadzadeh0Raphaela Brauns1Harald Hefter2Department of Neurology, University Hospital of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, University Hospital of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, University Hospital of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, GermanyBackground: The response to BoNT is not uniform; a broad spectrum of responses and side-effects usually occurs. This study aimed to show special cervical dystonia cases with therapy response very different to normal treatment course which indicate the extreme ends of therapy spectrum. Patients: Clinical data and course of treatment of five long-term treated patients with cervical dystonia out of therapy response norms are presented: a patient who was supersensitive to standard dose and has required dose adjustment to lower dose of BoNT; one patient who worsened under a standard dose, but responded excellently to twice the standard dose; one insensitive patient who responded poorly for years to a dose well above the standard dose, but responded when dose was further increased; and two patients with a totally different response pattern to BoNT/A preparation 1, but the development of a neutralizing antibody induced secondary treatment failure in both cases and a totally different response after switch to BoNT/A preparation 2. Conclusions: These five patients indicate that the response of a patient to a BoNT preparation may be unexpected. Therefore, cautious onset of BoNT therapy is recommended as well as consequent dose adjustment later on and even switch to another BoNT/A preparation when a patient has already developed NABs against BoNT/A.https://www.mdpi.com/2072-6651/13/1/22botulinum neurotoxinresponse spectrumhypersensitivityinsensitivityresponse behaviorneutralizing antibody |
| spellingShingle | Sara Samadzadeh Raphaela Brauns Harald Hefter The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia Toxins botulinum neurotoxin response spectrum hypersensitivity insensitivity response behavior neutralizing antibody |
| title | The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia |
| title_full | The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia |
| title_fullStr | The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia |
| title_full_unstemmed | The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia |
| title_short | The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia |
| title_sort | extreme ends of the treatment response spectrum to botulinum toxin in cervical dystonia |
| topic | botulinum neurotoxin response spectrum hypersensitivity insensitivity response behavior neutralizing antibody |
| url | https://www.mdpi.com/2072-6651/13/1/22 |
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