Objective: To investigate the causes of disability in patients with cervical dystonia.

Background: Despite the development of medical treatment, cervical dystonia impairs the daily living and working capacity. One reason might be that the duration of the treatment effect is not yet quite optimal. Another possible problem decreasing the working capacity might be depression, a common reason leading to premature retirement in the population.

Methods: The impact of botulinum treatment on the disability in cervical dystonia was assessed by inquiring the disability during the best and worst effect of botulinum toxin. The schedule of injections and the duration of the effect was asked as well. Depressive symptoms were assessed with the geriatric depression scale (GDS-15). The use of antidepressive medication was also documented. Altogether 117 of the total of 226 applicants for dystonia courses organized by the Finnish Parkinson Association (2006–2009) participated in the study. Of these, 70 persons had cervical dystonia (CD), and 76% of them were women.

Results: The mean age of the 70 participants with CD was 54.6 years (range 31–76) and the average (SD) time from the diagnosis was 5.0 (3.8) years. Only 29 respondents less than 65 years were working full-time (47%) and one part-time, 7 (11%) were unemployed. Botulinum toxin treatment was given to 63 (90%) of the participants, every 3.3 months on average (SD 0.9). Its response lasted on average 2.1 (SD 1.1) months. During the time, when the treatment effect was good, 22% experienced remarkable disability. When the botulinum toxin response was weak, 49% reported remarkable disability. The GDS-15 indicated at least mild depression in 28 respondents (40%). Of the participants, 12 (17%) were on regular medication for depression.

Conclusions: In spite of medical treatment, cervical dystonia often leads to disabilities and difficulties at work. The main problem leading to difficulties in employment might be that the effect of botulinum toxin lasts less than the interval of the injections. Nearly half of the participants had remarkable disability about four months a year because of lacking effect. At least mild depression is also a common problem among dystonia patients, and it should be effectively treated, too.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/yearly-four-months-disability-gap-in-cervical-dystonia-due-to-run-out-botulinum-toxin-effect/