Alleviating head tremor symptoms with botulinum toxin
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on November 29th, 2023
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Head tremor is a common movement disorder with a prevalence of approximately 1%. The disease is more common with old age: the disease prevalence increases to 5% in people above 65 years old. Without an effective treatment, the French Ministry of Health had funded a study to examine the possibility of using Botulinum toxin in managing head tremor.
The study included 117 patients whose average age was approximately 65 years old and had been experiencing head tremor. Assessment was conducted and enrolled patients whose head tremor severity was severe, which is equivalent to a score of 2 or higher on the Fahn-Tolosa-Marin Tremor scale. The participants were randomly assigned to be treated with either placebo or the botulinum toxin, which were administered intramuscularly at the splenius capitis muscle at the beginning of the trial and at the 12th week of research. Botulinum toxin was available in the form of onabotulinumtoxin A powder that can be reconstituted with saline before administration to a dose of 75 IU. The dose of onabotulinumtoxin A could be increased to 100 IU in the 12th week injection. After 18 week of monitoring, the researchers concluded that botulism toxin injection helped alleviate clinical symptoms in 31% of the patients as defined by a 2 point improvement on the Clinical Global Impression of Change scale. This rate of clinical improvement was significantly higher than the 9% reported in the placebo group. In terms of safety, the rate of dysphagia, neck pain, and posterior cervical weakness was significantly higher in the botulinum toxin group. These adverse events were considered as mild and transient.
The study included 117 patients whose average age was approximately 65 years old and had been experiencing head tremor. Assessment was conducted and enrolled patients whose head tremor severity was severe, which is equivalent to a score of 2 or higher on the Fahn-Tolosa-Marin Tremor scale. The participants were randomly assigned to be treated with either placebo or the botulinum toxin, which were administered intramuscularly at the splenius capitis muscle at the beginning of the trial and at the 12th week of research. Botulinum toxin was available in the form of onabotulinumtoxin A powder that can be reconstituted with saline before administration to a dose of 75 IU. The dose of onabotulinumtoxin A could be increased to 100 IU in the 12th week injection. After 18 week of monitoring, the researchers concluded that botulism toxin injection helped alleviate clinical symptoms in 31% of the patients as defined by a 2 point improvement on the Clinical Global Impression of Change scale. This rate of clinical improvement was significantly higher than the 9% reported in the placebo group. In terms of safety, the rate of dysphagia, neck pain, and posterior cervical weakness was significantly higher in the botulinum toxin group. These adverse events were considered as mild and transient.