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Original Paper

Electromyographic Quantification of the Paralysing Effect of Botulinum Toxin in the Sternocleidomastoid Muscle

Dressler D. · Rothwell J.C.

Author affiliations

MRC Human Movement and Balance Unit, Institute of Neurology, London, UK

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Eur Neurol 2000;43:13–16

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: January 12, 2000
Issue release date: January 2000

Number of Print Pages: 4
Number of Figures: 2
Number of Tables: 0

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: https://www.karger.com/ENE

Abstract

The effect of botulinum toxin (BT) upon the human body has so far been measured by using clinical scales monitoring its overall therapeutic effect upon the disorders treated. Clinical scales, however, usually lack sensitivity, are rarely validated and are integrating a number of uncontrollable parameters. After validation of the methodology in a group of 10 controls, we investigated the BT-induced amplitude reduction of the maximal voluntary electromyographic activity (M-EMG amplitude reduction) of the sternocleidomastoid muscle in a group of 34 patients with cervical dystonia undergoing regular BT therapy with Botox® (Allergan, Irvine, Calif., USA; n = 16) or Dysport® (Ipsen, Maidenhead, UK; n = 18). With Botox doses of 20 mouse units the M-EMG amplitude reduction was 80% (SD = 3.9%, n = 4), with 40 it was 84% (SD = 10.8%, n = 4), with 60 it was 85% (SD = 2.6%, n = 2) and with 80 it was 91% (SD = 5.8%, n = 6). With Dysport doses of 100 mouse units the M-EMG amplitude reduction was 70% (SD = 7.6%, n = 4), with 200 it was 85% (SD = 10.4%, n = 5), with 300 it was 83% (SD = 9.2%, n = 3), with 400 it was 78% (SD = 6.7%, n = 3) and with 500 it was 91% (SD = 5.8%, n = 5). The methodology presented can measure M-EMG amplitude reductions with a precision of about 10%. Dose-efficacy relationships can be used for dose optimisation, evaluation of BT therapy failure and comparison of different preparations and types of BT.

© 2000 S. Karger AG, Basel


References

  1. Moore P: Handbook of Botulinum Toxin Treatment. Oxford, Blackwell Science, 1995.
  2. Tsui JKC, Eisen A, Stoessl AJ, Calne S, Calne DB: Double-blind study of botulinum toxin in spasmodic torticollis. Lancet 1986;ii:245–247.
  3. Dressler D: Botulinum-Toxin-Therapie. Stuttgart, Thieme, 1995.
  4. Pearce LB, Borodic GE, First ER, MacCallum RD: Measurement of botulinum toxin activity: Evaluation of the lethality assay. Toxicol Appl Pharmacol 1994;128:69–77
  5. Goeschel H, Wohlfahrt K, Frevert J, Dengler R, Bigalke H: Botulinum A toxin: Neutralizing and non-neutralizing antibodies – Therapeutic consequences. Exp Neurol 1997;147:96–102.
    External Resources
  6. Dressler D, Dirnberger G, Bhatia K, Quinn NP, Irmer A, Bigalke H: Comparison of the mouse diaphragm bioassay and the mouse lethality bioassay. Mov Disord, in press.
  7. Dressler D, Rothwell JC, Marsden CD: Comparing biological potencies of Botox® and Dysport® with a mouse diaphragm model may mislead. J Neurol 1998;245:332.
    External Resources

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: January 12, 2000
Issue release date: January 2000

Number of Print Pages: 4
Number of Figures: 2
Number of Tables: 0

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: https://www.karger.com/ENE


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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