Long-term Distant
Effect of Locally Administred Botulinum Toxin on Neuromuscular Transmission
Adamová B., Leberová D.1, Voháňka S.1, Bednařík J., Bartošíková L.1
Neurologická klinika LF MU a FN, Brno 1Farmaceutická fakulta Veterinární a farmaceutické univerzity, Brno |
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Summary:
Longitudinal study of the neuromuscular jitter of the extensor digitorum communis muscle was done
in 1993 in 10 patients treated with botulinum toxin A (BTXA) by means of stimulated single fibre
electromyography (SF EMG). The examination was done before the administration and twice after the
BTXAadministration in order to follow up the effect of such therapy on the neuromuscular transmission
in remote muscles.The BTXA administration brought about only a small, transient, subclinical increase
of jitter. In 7 out of 10 patients who were treated with BTXA for abnormal movements, the SF EMG
examination was repeated after 7 to 8 years. In each patient at least 20 neuromuscular junctions were
examined (individual jitter MCD) and the mean individual jitters (mean MCD) was estimated. Also the
average value of jitter from all patients was estimated (pooled data). The average value of mean MCD
was in 1993 20 µs (15–25 µs, SD 3.1 µs) in years 2000–2001 21 µs (17–26 µs, SD 3.0 µs). The pooled value of
individual jitters was in 1993 19,46 µs (SD 8.59 µs), after 7 to 8 years it was 21.01 µs (SD 9.76 µs). Differences
are not significant (p=0.59, 0.23 respectively). The study has shown that the small increase of neuromuscular
jitter just after the BTXA administration is a transient effect and with long-term administration
it has no cumulative effect on the injury of the neuromuscular transmission in remote muscles.
Key words:
botulinum toxin, single fiber electromyography, neuromuscular jitter
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