Botulinum toxin for neurological disorders in a movement disorders clinic in Singapore

This study was done to examine the usefulness of botulinum toxin A injections in treating various neurological disorders such as hemifacial spasm, blepharospasm, focal dystonia and task-specific dystonia.

This was a prospective, open-labelled trial of patients seen in a Movement Disorders Clinic with dyskinesias potentially treatable with botulinum toxin. All patients were assessed before and after injections using clinical rating scales, and those with focal and task-specific dystonias were also recorded on videotape.

There were 102 patients with hemifacial spasm, 3 with blepharospasm, 13 with neck dystonia, 6 with writer's cramp, I with musician's cramp, and I with jaw dystonia. All patients with hemifacial spasm and blepharospasm obtained good results, while 77% of those with cervical dystonia received substantial benefit. Only half of those with writer's cramp improved. Hemifacial spasm seems more prevalent in Singapore compared with Western populations.

Injections of botulinum toxin are useful in treating the various neurological disorders studied. This is an advancement in the treatment of these dyskinesias which respond poorly to oral medications.