Objective: To compare the therapeutic efficacy of BT injections for spasticity and dystonia in the limbs.

Background: Botulinum toxin (BT) shows promise in alleviating limb dystonia, but limited insurance coverage hinders its utilization.

Method: BT injections were administered under ultrasound guidance. Prior to each treatment, some forms were completed: patient-reported global impression of change from baseline (PGI-C), clinician-rated global impression of severity (CGI-S) and subjective report on motor function and pain.

Results: From 58 patients, 46 diagnosed with spasticity and 12 with dystonia. Totally, 177 therapeutic cycles were administered. The dropout rates were 75.9% in the spasticity group and 63.6% in the dystonia group (p=0.35). Dystonia patients received more treatment cycles than patients with spasticity (4.7±3.6 vs. 2.8±2.3 cycles respectively, p<0.001), with comparable dosages. The mean dose for the whole group was 191.8±130.9 units. There was no significant difference in Motor improvement between dystonia and spasticity (51.8±28.5 vs. 41.3±32.6% respectively, p=0.16). Dystonia patients reported significantly better pain relief (91.9±27.2% vs. 53.3±40.8% respectively, p<0.001). Notably, 73.8% of dystonia treatments reported moderate or marked improvement, whereas only 53.5% of spasticity treatments did (p>0.05). Limb weakness was the most common side effect, affecting 20.5% of the dystonia patients versus 14% of the patients with spasticity (p>0.05), with other side effects being infrequent.

Conclusion: BT injections show partial efficacy in treating limb spasticity and dystonia, but high dropout rates are a concern. Notably, BT injections appear to be more effective for dystonia than for spasticity, particularly when administered during the advanced stages of spasticity.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comparison-in-therapeutic-outcome-of-ultrasound-guided-botulinum-injections-for-limb-spasticity-versus-dystonia/