Mixed effectiveness of rTMS and retraining in the treatment of focal hand dystonia.

Unlabelled: Though the pathophysiology of dystonia remains uncertain, two primary factors implicated in the development of dystonic symptoms are excessive cortical excitability and impaired sensorimotor processing. The aim of this study was to determine the functional efficacy of an intervention combining repetitive transcranial magnetic stimulation (rTMS) and sensorimotor retraining. A randomized, single-subject, multiple baseline design with crossover was used to examine participants with focal hand dystonia (FHD) (n = 9).

Virtual trainer for intra-detrusor injection of botulinum toxin to treat urinary incontinence.

Here we introduce a new virtual reality (VR) based simulation system for training the urological procedure of intra-detrusor botulinum toxin (Botox®) injections into the bladder. 6 cases with different bladder anatomy and 3 subtasks are included in the curriculum; this design is guided by several expert urologists according to clinical needs and experience. These virtual bladder models can be deformed by a cystoscope model or penetrated by a needle model.

Efficacy of intra-articular botulinum toxin type A in painful knee osteoarthritis: a pilot study.

Objective: To evaluate the efficacy and safety of botulinum toxin type A (BoNT-A) injected intra-articularly in 60 subjects with moderate pain and functional impairment secondary to knee osteoarthritis. The study investigators hypothesized that intra-articular BoNT-A would result in statistically significant improvements in pain and function at 8 weeks.

Design: Double-blind, randomized, single tertiary care academic medical center trial with 6-month follow-up.

Intra-articular Botulinum Toxin Type A: a new approach to treat arthritis joint pain.

There is a growing need for novel treatments of refractory arthritis joint pain as the aging population is expanding with many patients who are unable to undergo joint replacement surgery. We are studying the efficacy and safety of intra-articular injection of Botulinum Toxin Type A (IA-BoNT/A) into joints with arthritis pain. In several small open label studies, initial effects for IA-BoNT/A were encouraging because two thirds of the patients had more than 50% reduction in joint pain severity that was associated with a significant improvement in function.

Botulinum toxin type A for the treatment of provoked vestibulodynia: an open-label, pilot study.

Objective: To evaluate the effects of botulinum toxin type Afor the treatment of provoked vestibulodynia.

Study Design: Open-label, dose-escalation, pilot study. Primary outcome measure was a standard numeric pain rating scale of 0-10.

Treatment of cervical dystonia and focal hand dystonia by high cervical continuously infused intrathecal baclofen: a report of 2 cases.

We describe 2 patients, one with cervical dystonia (CD) combined with focal hand dystonia (writer's cramp) and another with idiopathic CD, who were unresponsive to oral medications and became resistant to botulinum toxin type A and B injections. Both patients were successfully treated with high cervical (C1-3) continuously infused intrathecal baclofen (ITB). Neck range of motion (ROM) was measured by using a 3-dimensional electromagnetic cervical ROM system.

Treatment of overactive bladder with botulinum toxin type B: a pilot study.

The purpose of this study was to determine the efficacy and safety of botulinum toxin type B (BTX-B/Myobloc) in the treatment of patients with overactive bladder. This open-label dose-escalation study enrolled 15 female patients with urinary frequency with or without incontinence. The BTX-B doses used in this study were 2500, 3750, 5000, 10 000 and 15 000 units.

Botulinum toxin in the management of bowel and bladder function in spinal cord injury and other neurologic disorders.

Botulinum toxin inhibits release of acetylcholine and other neurotransmitters. It has been used successfully to treat pain and abnormal skeletal and smooth muscle activity in patients. This article discusses its use in patients with bladder and bowel disorders.

Use of botulinum toxin type B for the treatment of detrusor hyperreflexia in a patient with multiple sclerosis: a case report.

We describe a patient with multiple sclerosis (MS) who had detrusor hyperreflexia that was not responsive to oral medications or clean intermittent catheterization. This patient was successfully treated with 2 separate injections of botulinum toxin type B into the bladder. The results of the treatment lasted 4 months and there were no side effects.

Maximizing extraction of botulinum toxin type A from vials.

Objectives: To determine the residual botulinum toxin remaining in vials after using 3 different extraction methods and to analyze the different techniques for measuring extraction efficacy.

Design: Multicentered comparative study.

Setting: Three academic movement disorder clinics.