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Specific characteristics of the medical history of swallowing before and after application of botulinum toxin in patients with cervical dystonia
Vilanova, Tatiana Fonseca Del Debbio; Borges, Vanderci; Ferraz, Henrique Ballalai.
  • Vilanova, Tatiana Fonseca Del Debbio; Universidade Federal de Sao Paulo (UNIFESP). Setor de Transtornos do Movimento. Sao Paulo. BR
  • Borges, Vanderci; Universidade Federal de Sao Paulo (UNIFESP). Setor de Transtornos do Movimento. Sao Paulo. BR
  • Ferraz, Henrique Ballalai; Universidade Federal de Sao Paulo (UNIFESP). Setor de Transtornos do Movimento. Sao Paulo. BR
Clinics ; 74: e776, 2019. tab, graf
Article in English | LILACS | ID: biblio-989643
ABSTRACT

OBJECTIVES:

To compare signs and symptoms of dysphagia in individuals with cervical dystonia (CD) before and after application of botulinum toxin (BTX).

METHODS:

A prospective study was conducted with 20 patients diagnosed with CD with indications for BTX application. We selected 18 patients who met the study inclusion criteria. All individuals were patients from the Movement Disorders Unit, Department of Neurology, Federal University of São Paulo. BTX was applied in the cervical region at the necessary dose for each individual. To identify signs/complaints of changes in swallowing, we used a specific questionnaire that was completed by patients and/or their companions on the day of BTX injection and repeated 10 to 15 days after BTX injection.

RESULTS:

Among the 18 study subjects, 15 (83.3%) showed primary and three (16.7%) showed secondary cervical dystonia. The most frequent dystonic movements were rotation (18), tilt (5), forward shift (3), backward shift (7), shoulder elevation (12), shoulder depression (2), and cervical tremor (6). The main complaints reported before BTX application were voice changes in 10 (55.6%), need for adjustment of eating position in 10 (55.6%), coughing and/or choking while eating in nine (50%), and increased eating time in nine (50%) individuals. The main complaints reported after BTX application were coughing and/or choking while eating in 11 (61.1%), voice changes in nine (50%), sensation of food stuck in the throat in eight (44%), and increased eating time in eight (44%) individuals.

CONCLUSION:

The administration of a swallowing-specific questionnaire to individuals with CD before and after BTX application enabled the identification of possible dysphagia symptoms prior to drug treatment resulting from CD, which are often subsequently interpreted as side effects of the drug treatment. Thus, dysphagia can be managed, and aspiration symptoms can be prevented.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Deglutition Disorders / Botulinum Toxins, Type A / Deglutition / Dystonia / Neuromuscular Agents Type of study: Observational study / Prognostic study Limits: Adolescent / Adult / Female / Humans / Male Language: English Journal: Clinics Journal subject: Medicine Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de Sao Paulo (UNIFESP)/BR

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Full text: Available Index: LILACS (Americas) Main subject: Deglutition Disorders / Botulinum Toxins, Type A / Deglutition / Dystonia / Neuromuscular Agents Type of study: Observational study / Prognostic study Limits: Adolescent / Adult / Female / Humans / Male Language: English Journal: Clinics Journal subject: Medicine Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de Sao Paulo (UNIFESP)/BR