Does ultrasound-guidance improve the outcome of botulinum toxin injections in cervical dystonia?
Rev Neurol (Paris)
; 178(6): 591-602, 2022 Jun.
Article
em En
| MEDLINE
| ID: mdl-34916042
ABSTRACT
PURPOSE:
Ultrasound-guided injections of botulinum neurotoxin in cervical dystonia have a number of theoretical advantages. However, their action has never been compared to that of non-guided injections. The objectives of the study were to compare the outcome of botulinum neurotoxin type A treatment in patients with idiopathic, focal cervical dystonia, according to twomethods:
inspection and palpation of anatomical landmarks (non-guided group) or ultrasound guidance (ultrasound-guided group).METHODS:
We included consecutive patients in this single-center, prospective, real-life, non-randomized study. The outcomes were evaluated one month after the injections Cervical Dystonia Impact Profile 58 (main outcome), Toronto Western Spasmodic Torticollis Rating Scale-2 (pain and disability subscores), Toronto Western Spasmodic Torticollis Rating Scale-PSYCH, patient-rated Clinical Global Impression - Improvement and adverse events. We used propensity score methods for statistical analysis; ten predefined confounding factors were used to build the propensity score.RESULTS:
Sixty-three patients were included in the non-guided group, and 60 other patients in the ultrasound-guided group. We found no difference in main and secondary outcomes between the two study groups.CONCLUSION:
This is the first direct comparison between ultrasound-guided and non-guided botulinum neurotoxin type A injections in patients with cervical dystonia. We hypothesize that ultrasound guidance made it possible to obtain the same results in the most severe (or the most demanding) patients as in the best responders. Further studies are still needed to assess the impact of botulinum neurotoxin injections into deep cervical muscles.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Torcicolo
/
Toxinas Botulínicas Tipo A
/
Fármacos Neuromusculares
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Guideline
/
Observational_studies
Limite:
Humans
Idioma:
En
Revista:
Rev Neurol (Paris)
Ano de publicação:
2022
Tipo de documento:
Article