Â鶹´«Ã½Ó³»­

Â鶹´«Ã½Ó³»­

Explore the latest content from across our publications
Join The Â鶹´«Ã½Ó³»­

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Chemo-denervation of Oromandibular Dystonia with Botulinum toxins: Five-year experience
Movement Disorders
P16 - Poster Session 16 (5:30 PM-6:30 PM)
3-016
To review experience of Botulinum Toxin (BoNT) injections for Oromandibular Dystonia (OMD).
OMD causes sustained or repetitive, forceful contractions of the muscles involving jaw and tongue causing jaw opening, jaw closing, lingual and mixed dystonias. When oral pharmacologic agents are inadequate, BoNT is standard of care. 
A single center, retrospective chart review (July 2013 - June 2018) of BoNT injections for OMD. Wastage was defined as leftover drug from the vial; prepared but not injected. Patient not receiving injections within last 6 months was considered a ‘dropout’. 

We had 43 patients (21 females), median age 58 years (range 21-88) with 231 encounters (avg. 5.4/patient, range 1-16). Most commonly used toxin was OnabotulinumToxinA (OnaBoNT, 88%), and very few patients with IncobotulinumToxinA (IncoBoNT, n=3) and RimabotulinumToxinB (RimaBoNT, n=2). Jaw closing dystonia was more common (70%, 60% females) then jaw-opening (21%) and lingual dystonia (21%) with overlap. Isolated Lingual dystonia injections were rare (11%), commonly associated with jaw opening (56%); while Jaw opening injections were never solitary. Isolated Jaw closing injections were also uncommon (23%) and frequently associated with cervical (40%) and facial (40%) injections. 

Average total dose (in Units, with range) of OnaBoNT was 66 (10-180) for Jaw closing; 54 (30-100) for Jaw opening and 16 (5-30) for Lingual dystonia. RimaBoNT (1000- 2000) and IncoBoNT (45-50) were only used for Jaw closing dystonia. Average wastage of Botox was 25 units/patient. Dropout rate over 5 years was 37% after average 4 sessions (range 1-11). Most common reason was lost to follow up (22%) and deceased (22%), while lack of benefits (17%) and side effects (dysphagia 17% and weakness 11%) were uncommon reasons. 
In our series, jaw-closing dystonia was the most frequent and most OMD were segmental in nature. Although side effects and lack of benefit are infrequently reported, dropout was common.
Authors/Disclosures

PRESENTER 		No disclosure on file
Nabeel M. Syed, MBBS (Shifa International Hospital) No disclosure on file
John M. Bertoni, MD, PhD, FÂ鶹´«Ã½Ó³»­ (University of Nebraska Medical Center) Dr. Bertoni has nothing to disclose.
Amy Hellman, MD, FÂ鶹´«Ã½Ó³»­ (University of Nebraska Medical Center) The institution of Dr. Hellman has received research support from COBRE-NIH. The institution of Dr. Hellman has received research support from Neurocrine.
Diego Torres-Russotto, MD, FÂ鶹´«Ã½Ó³»­ (Miami Neuroscience Institute - Baptist Health South Florida) Dr. Torres-Russotto has received personal compensation for serving as an employee of Movement Disorders Consulting, Inc. The institution of Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AbbVie. The institution of Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine. The institution of Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Revance. The institution of Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Anneal. Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for IPSEN. Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. The institution of Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie. The institution of Dr. Torres-Russotto has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurocrine. Dr. Torres-Russotto has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Your Nest Asset Solutions, LLC. Dr. Torres-Russotto has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Bright Future Asset Solutions, LLC.
Danish Bhatti, MD, FÂ鶹´«Ã½Ó³»­ (University of Central Florida College of Medicine) Dr. Bhatti has nothing to disclose.