Objective: To describe the current situation of training and practices among physicians using botulinum neurotoxin-A (BoNT-A) injections in the treatment of Cervical Dystonia (CD) and Spastic Paresis (SP).

Background: BoNT-A is commonly used as the first line treatment for CD and SP. However, proper administration of BoNT-A requires specific training and the effectiveness of BoNT-A treatment is highly dependent on the experience of clinicians.

Methods: A multidisciplinary Steering Committee designed a self-completion questionnaire on experience, training and confidence in different BoNT-A injection techniques and rehabilitation methods. The questionnaire was completed by 17 experts managing patients with SP and CD, selected among the Ixcellence Network®(IN) faculty. Here we present a preliminary analysis of their answers. These results will be supplemented by additional data (which will be available for the congress) from a database of more than 700 practitioners who participated in the IN courses.

Results: The questionnaire was completed by 17 physicians specialized in physical medicine and rehabilitation (9/17), neurology (7/17) and pediatric neurology (1/17), with an average experience of 22 years in their field and 18 years in BoNT-A injection. All received training prior to first injection, complete with dedicated sessions on guidance techniques: 15 on ultrasound (US), 11 on anatomical landmarks, 6 on electrostimulation (ES) and 7 on electromyography (EMG). In the respondents’ current practice, BoNT-A injection was performed without guidance by 14 of them. However, guidance techniques were also sometimes used: US (15/17), ES (11/17) and EMG (10/17). Fifteen physicians also received specific training on rehabilitation methods for SP (11), CD (1) or both (3). Overall, self-confidence in using injection techniques or rehabilitation methods was greater among physicians who had attended specific training.

Conclusions: Our preliminary results highlight the importance of BoNT-A training since most physicians adopt the method that they feel most comfortable in their routine practices. Moreover, attending specific courses was associated with greater self-confidence.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/first-results-from-the-ixcellence-network-survey-botulinum-neurotoxin-a-usage-and-training-in-cervical-dystonia-spastic-paresis/