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The use of botulinum toxin type-B in the treatment of patients who have become unresponsive to botulinum toxin type-A - initial experiences

Lookup NU author(s): Professor Michael Barnes

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Abstract

The increasing use of botulinum toxin type-A, especially for focal dystonia and spasticity has highlighted the issue of secondary non-responsiveness. Within the last few years botulinum toxin type-B (Myobloc(R)(/Neurobloc(R)) has become commercially available as an alternative to type-A. This paper discusses our initial experience of botulinum toxin type-B in a total of 63 individuals who attended our botulinum clinic. Thirty-six patients had cervical dystonia and a secondary non-response to type-A toxin. Thirteen of these patients (36%) had a reasonable clinical response to Neurobloc(R) and continue to have injections. The other 23 patients either had no response, or a poor response, or had unacceptable side effects and ceased treatment. A small number of people with blepharospasm, hemifacial spasm and foot dystonia also had a disappointing response to injection. Twenty patients with spasticity were also type-A resistant. Seven of these show some continuing response to type-B, without unacceptable side effects. These findings demonstrate that botulinum toxin type-B has a place in the management of patients who have become non-responsive to type-A, but overall the responses to type-B toxin were disappointing.

Publication metadata

Author(s): Barnes MP, Best D, Kidd L, Roberts B, Stark S, Weeks P, Whitaker J

Publication type: Article

Publication status: Published

Journal: European Journal of Neurology

Year: 2005

Volume: 12

Issue: 12

Pages: 947-955

ISSN (print): 1351-5101

ISSN (electronic): 1468-1331

Publisher: Wiley-Blackwell Publishing Ltd.

URL: http://dx.doi.org/10.1111/j.1468-1331.2005.01095.x

DOI: 10.1111/j.1468-1331.2005.01095.x

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