Neu-botulinum Toxin Type A (Neuronox(R) - botulinum toxin type A product by medyceles company , Korea) 50 units Intramuscular injection in the affected neck muscle that cause cervical dystonia every 12 weeks for 24 weeks ( 2 times , 12 week interval)

Abo-botulinum Toxin Type A (Dysport (R) - botulinum toxin type A product by IPEN company, France ) 250 unit Intramuscular Injection in the affected neck muscle that cause cervical dystonia every 12 weeks for 24 weeks (2 times , 12 week interval)

Cervical Dystonia

Injection botulinum toxin intramuscular for affected neck muscle

Neuronox(R)

Dysport (R)

Assistant Professor Subsai Kongsaengdao

Lampang Hospital

Surat Thani hospital

Sappasithiprasong Hospital

Abobotulinum Toxin and Neubotulinum Toxin Injection in Cerivical Dystonia

A 48-Week Prospective, Double-Blinded, Randomized, Cross-over Design in Multicenter Study of 250 Unit of Dysport Versus 50 Unit of Neuronox Injection For Cervical Dystonia in Thai Patients

TWSTRS ranged( 0-85 by summation of all 3 sub- scales ) higher represent a worse outcome TWSTRS Sub- scale includes
TWSTRS-Total severity scale ( maximum 35 points)
TWSTS-Disability scale (maximum 30 points)
TWSTS-Pain scale (maximum 20 points)

) Cervical Dystonia Impact Profile-58 items composed of 8 sub-scale Total score by summation of 8 subscale higher represent a worse outcome Analysis both total score (range 58-290 points) And sub-scale analysis composed of Head and neck symptoms ( 6 items ; 6-30 points) Pain and discomfort ( 5 items ; 5-25 points) Upper limb activity ( 9 items ; 9-45 points) Walking ( 9 items ; 9-45 points) Sleep ( 4 items ; 4-20 points) Annoyance ( 8 items ; 8-40 points) Mood (7 items ; 7-35 points) Psychosocial functioning ( 10 items ; 10-50 points)

Comparesion the quality of life (SF 36) pre- and post- 12 and 24 week ttreatment with 50 unit of Neubotulinum Toxin Type A (Neuronox) and 250 unit of Abobotulinum Toxin Type A (Dysport) this score has special formula calculation

Comparesion of CES-D pre- and post- 12 and 24 week treatment with 50 unit of Neubotulinum Toxin Type A (Neuronox) and 250 unit of Abobotulinum Toxin Type A (Dysport) Score ranged from 20-80 points higher represent a worse outcome

Comparesion of PHQ-9 pre- and post- 12 and 24 week treatment with 50 unit of Neubotulinum Toxin Type A (Neuronox) and 250 unit of Abobotulinum Toxin Type A (Dysport) There is the special scale calculation for diagnosis Major depressive disorder, Other depressive disorder and others,higher points /score represent a worse outcome ranged 0-27 points plus 3 points Total summation of 5-9 points indicate Minimal symptoms, 10-14 Minor depression ++ or Dysthymia* or Major depression, mild , 15-19 points Major depression, moderately severe
≥ 20 Major depression, severe

Comparesion of CGIC pre- and post- 12 and 24 week treatment with 50 unit of Neubotulinum Toxin Type A (Neuronox) and 250 unit of Abobotulinum Toxin Type A (Dysport)

Dr Subsai Kongsaengdao

Associated Professor

Rajavithi Hospital

BTX-A will be reconstituted as directed by the manufacturer. 2.5 mL of diluent (0.9% Saline) per 100 U vial will be used to reconstitute the solution while swirling. This creates a solution with a concentration of 4 U/0.1 mL. Patients will be seated and all usual precautions of sterility and skin preparation will be completed (i.e. alcohol wipes) Injections will be administered unilateral and/or bilaterally in accordance with the topography of the corresponding muscles (temporalis and masseter) into areas of maximal tenderness and pain. Plastic single use insulin syringes with 30 gauge needles will be used to inject 30 U intramuscularly into each masseter, divided evenly into 5 sites and 20 U will be injected into each temporalis, divided evenly over 5 sites. Injections will be completed by the principal investigator and supervisors who will be trained in botulinum toxin injections.

Temporo-Myofascial Disorder

Botulinum Toxin Type A

Treatment of Temporo-Myofascial Disorder of Muscular Origin Using Botulinum Toxin: A Prospective Study

Subjective pain scores will be assessed on a visual analog scale (VAS) where 0 is no pain and 10 is the worst facial or jaw pain they've ever experience. Subjective functional assessments will also be assessed with VAS where 0 means no limitation and 10 indicates severe limitation with scales for chewing, drinking, exercising, eating hard food, eating soft food, smiling or laughing, cleaning their teeth, yawning, swallowing and talking.

Range of motion will be assessed with a Boley gauge between the same upper and lower incisor each time

Pain to pressure will be ranked from 0 to 5, with 0 indicating no pain and 5 representing extreme debilitating pain. Addition of each score will give a composite score of the overall facial tenderness out of a maximal score of 24 (2 areas X 6 scores X bilaterally).

A point inferior to each ear lobule bilaterally will be marked as well as a point on the menton will be chosen and recorded. The distance unilaterally from one lobule to menton will be measured for left and right sides and a total distance will also be calculated to assess facial width.

University of Manitoba

Botulinum Toxin injections at adductors and triceps surae

Placebo injections at adductors and triceps surae

Hereditary Spastic Paraplegia

Each patient in the treatment group will receive 400 units of botulinum toxin. 100 units will be injected at adductors at each leg and 100 units will be applied in each triceps surae bilaterally.

Botulinum Toxin Injections

Each patient in the placebo group will receive sterile sodium chloride injections at adductors and triceps surae muscles bilaterally.

Placebo Injections

Univeristy of Campinas Hospital

Effects of Botulinum Toxin Injections in Patients With Hereditary Spastic Paraplegia

Botulinum Toxin in Patients With Hereditary Spastic Paraplegia: a Randomized, Double-blind, Placebo-controlled, Crossover Study

The primary outcome measure will be change from baseline in maximum gait velocity. Each patient will be asked to walk a 10 meter distance barefooted 3 times, as fast as he can. The average velocity between the 3 trials will be used as the final measure. Assistive devices are permitted.

The same neurologist will examine the patient to evaluate change at the SPRS scale

The same neurologist will examine the patient to evaluate change from baseline

this scale will be applied by a neurologic physiotherapist

Marcondes Cavalcante França Júnior

MD, Phd

University of Campinas, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Cristália Produtos Químicos Farmacêuticos Ltda.

Bruxism

week 1: the patient will undergo the following: a. physical examination; b. sleep questionnaire c. bruxism questionnaire to establish a clinical diagnosis of bruxism; d. headache questionnaire; e. Clinical Global Improvement scale; f. masseter muscle measurement; g. anxiety questionnaire; h. demographic questionnaire;
week 2: The patient undergoes a polysomnogram (sleep study). The patient will spend one night (10:30pm-8:00am or until spontaneous awakening) in a sleep lab. During the sleep study, the following parameters will be recorded: electroencephalogram, electro-oculogram, upper airway resistance, heart rate, muscle activity; upper airway resistance,masseter muscles bilaterally. All recordings are performed using surface electrodes (self-adhesive to the skin), none of them invasive.
Study visit 3 (week 3): Patients are injected with botulinum toxin type A (BOTOX) 60 units in each masseter muscle and 35 in each temporalis muscle, bilaterally.

torticollis/insult

Abobotulinum Toxin and Neubotulinum Toxin Injection in Cerivical Dystonia

Treatment of Temporo-Myofascial Disorder of Muscular Origin Using Botulinum Toxin: A Prospective Study

Effects of Botulinum Toxin Injections in Patients With Hereditary Spastic Paraplegia

Study of the Safety and Efficacy of Botox in Bruxism

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