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The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia

Department of Neurology, University Hospital of Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany
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Toxins 2021, 13(1), 22; https://doi.org/10.3390/toxins13010022
Received: 7 November 2020 / Revised: 21 December 2020 / Accepted: 28 December 2020 / Published: 31 December 2020
(This article belongs to the Special Issue Clostridium Neurotoxins)
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. View Full-Text
Keywords: botulinum neurotoxin; response spectrum; hypersensitivity; insensitivity; response behavior; neutralizing antibody botulinum neurotoxin; response spectrum; hypersensitivity; insensitivity; response behavior; neutralizing antibody
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MDPI and ACS Style

Samadzadeh, S.; Brauns, R.; Hefter, H. The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia. Toxins 2021, 13, 22. https://doi.org/10.3390/toxins13010022

AMA Style

Samadzadeh S, Brauns R, Hefter H. The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia. Toxins. 2021; 13(1):22. https://doi.org/10.3390/toxins13010022

Chicago/Turabian Style

Samadzadeh, Sara; Brauns, Raphaela; Hefter, Harald. 2021. "The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia" Toxins 13, no. 1: 22. https://doi.org/10.3390/toxins13010022

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