Clinical Analysis Of Long-term Effectiveness And Relevant Factors Of Botulinum Toxin Serotype A On The Treatment Of Spasmodic Torticollis

Objective Investigating the influence of several factors: age of onset, gender,courseof disease on the long-term effectiveness of botulinum toxin serotype A in treatingspasmodic torticollis.Methods54patients diagnosed as spasmodic torticollis from January2009to August2012in the Second Affiliated Hospital of Soochow University were chose for the treatmenton the sternocleidomastoid, capitis, neck splenius，trapezius, scapular muscles, scalenemuscle of musculi colli with local injection under the guidance of electromyography. Theage of onset, duration (onset to first botulinum toxin serotype A treatment time), gender,clinical type, severity and other factors were analyzed on the long-term effects ofbotulinum toxin, and safety observation was conducted follow-up by telephone or referralwas taken before treatment, after treatment of15days,1month,3months,6months,18months,42months，respectively. When patients were given the lastinjection, the therapeutic effect showed after18months was used to judge.Results47patients completed the final follow-up.21patients (68%) were effectiveafter31patients were treated by the injection of botulinum toxin serotype A by once, and13patients (81%) were effective after16patients were treated by the injection ofbotulinum toxin serotype A by twice and more than twice;26patients (84%) were effectivein31patients which aged <45years, and8patients (50%) were effective in16patientswhich aged≥45years.The aged <45years age group was significantly better than theaged≥45years group (P=0.020);27patients (82%) were effective in33patients whichduration <3years, and7patients (50%) were effective in14patients which duration≥3years. The duration <3years group was significantly better than the duration≥3year group(P=0.026); There were no significant influence on the efficacy of botulinum toxin type Aby the gender, clinical type, severity of illness (P=0.664, P=0.596, P=0.693). Of47patients,15patients showed weakness of neck,4patients showed difficulty inswallowing,1patient showed influenza-like symptoms, and2patients showedtrachelodynia, which were released naturally.Conclusion The long-term treatment of botulinum toxin serotype A on the spasmodictorticollis was effective and safe. The age of onset, duration of disease had significantinfluence on the effect of botulinum toxin serotype A treatment on the spasmodictorticollis.