RESUMO
Botulinum toxin (BTA) is a safe and effective therapeutic tool for many neurological conditions but few studies have investigated its real cost in neurological practice. We evaluated the daily cost of botulinum toxin type A (BTA) treatment through a cost effectiveness analysis alongside a prospective study of BTA injections at a French University Hospital over a 2-year follow-up period. The data of 3,108 BTA injections performed in 870 adult patients presenting with dystonia, facial hemispasm, or spasticity were entered in the database. Patients were questioned at each visit about the subjective effectiveness of the previous injection. The daily cost of BTA treatment was calculated as the ratio of each session's cost (including all additional costs) to the duration of subjective efficacy. The subjective rating of efficacy duration was 17.3 ± 7.7 weeks for facial hemispasm, 15.4 ± 7.7 for blepharospasm, 14.3 ± 6.7 for cervical dystonia, 14.5 ± 7.8 and 14.1 ± 7.4 weeks for upper and lower limb spasticity, respectively. The daily cost of BTA injections was 0.57 ± 0.20
Assuntos
Toxinas Botulínicas Tipo A/economia , Custos de Medicamentos , Fármacos Neuromusculares/economia , Doenças Neuromusculares/tratamento farmacológico , Doenças Neuromusculares/economia , Adulto , Idoso , Toxinas Botulínicas Tipo A/uso terapêutico , Estudos de Coortes , Análise Custo-Benefício/métodos , Custos de Medicamentos/tendências , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Neuromusculares/uso terapêutico , Doenças Neuromusculares/fisiopatologia , Guias de Prática Clínica como Assunto/normas , Estudos ProspectivosRESUMO
During a period of intensive practice, 2 petanque players developed freezing of shoulder flexion impeding boule throwing. This movement disorder was consistent with the diagnosis of task-specific focal dystonia. Polymyography showed that freezing was associated with bursts of low amplitude. In the absence of motor or sensory deficits, a motor apraxia could be considered.