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Open AccessArticle

Jitter Evaluation in Distant and Adjacent Muscles after Botulinum Neurotoxin Type A Injection in 78 Cases

1
Laboratório Investigação Neuromuscular (LIN), Faculdade Estadual Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto SP 15090-000, Brazil
2
Departamento de Ciências Neurológicas, Fundação Faculdade Regional de Medicina São José do Rio Preto (FUNFARME), São José do Rio Preto SP 15090-000, Brazil
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(9), 549; https://doi.org/10.3390/toxins12090549
Received: 16 July 2020 / Revised: 20 August 2020 / Accepted: 25 August 2020 / Published: 27 August 2020
(This article belongs to the Section Bacterial Toxins)
To study the jitter parameters in the distant (DM) and the adjacent muscle (AM) after botulinum neurotoxin type A (BoNT/A) injection in 78 patients, jitter was measured by voluntary activation in DM (n = 43), and in AM (n = 35). Patients were receiving BoNT/A injections as a treatment for movement disorders. Mean age 65.1 years (DM) and 61.9 years (AM). The mean jitter was abnormal in 13.9% (maximum 41.4 µs) of DM, and 40% (maximum 43.7 µs) of AM. Impulse blocking was sparse. We found no correlation of the mean jitter to age, BoNT/A most recent injection (days/units), number of muscles injected, total BoNT/A units summated, number of total BoNT/A sessions, beta-blockers/calcium channel blockers use, and cases with local spread symptoms such as eyelid drop/difficulty swallowing. Maximum mean jitter (41.4/43.7 µs) for DM/AM occurred 61 and 131 days since the most recent BoNT/A, respectively. The far abnormal mean jitter (32.6/36.9 µs) occurred 229 and 313 days since the most recent BoNT/A. We suggested that jitter measurement can be done after BoNT/A in a given muscle other than the injected one, after 8 (DM) and 11 (AM) months, with reference >33 µs and >37 µs, respectively. View Full-Text
Keywords: single-fiber electromyography; jitter; botulinum neurotoxin type A; movement disorders; myasthenia gravis; neuromuscular junction single-fiber electromyography; jitter; botulinum neurotoxin type A; movement disorders; myasthenia gravis; neuromuscular junction
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MDPI and ACS Style

Kouyoumdjian, J.A.; Graça, C.R.; Oliveira, F.N. Jitter Evaluation in Distant and Adjacent Muscles after Botulinum Neurotoxin Type A Injection in 78 Cases. Toxins 2020, 12, 549. https://doi.org/10.3390/toxins12090549

AMA Style

Kouyoumdjian JA, Graça CR, Oliveira FN. Jitter Evaluation in Distant and Adjacent Muscles after Botulinum Neurotoxin Type A Injection in 78 Cases. Toxins. 2020; 12(9):549. https://doi.org/10.3390/toxins12090549

Chicago/Turabian Style

Kouyoumdjian, Joao A.; Graça, Carla R.; Oliveira, Fabio N. 2020. "Jitter Evaluation in Distant and Adjacent Muscles after Botulinum Neurotoxin Type A Injection in 78 Cases" Toxins 12, no. 9: 549. https://doi.org/10.3390/toxins12090549

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