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Chapter 15 - The Use of Botulinum Toxin in Tremors

Published online by Cambridge University Press:  02 November 2023

By
Shivam Om Mittal  and
Joseph Jankovic
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
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Summary

Tremor is one of the common movement disorders encountered by neurologists in clinical practice. Based on the history and phenomenology, the tremor can be classified commonly as Parkinson’s disease tremor, essential tremor , essential tremor plus, dystonic tremor, task-specific tremor and other tremor syndromes. This chapter describes the role of botulinum neurotoxin (BoNT) in several tremor conditions and provides some practical clinical pearls related to BoNT injection techniques. Specific muscles involved and the dose range of BoNT are tabulated.

Keywords

Parkinson’s tremoressential tremordystonic tremorhand tremorhead tremorvoice tremorbotulinum neurotoxinBoNT
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 113 - 119
Publisher: Cambridge University Press
Print publication year: 2023

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References

Adler, CH, Bansberg, SF, Hentz, JG et al. (2004). Botulinum toxin type A for treating voice tremor. Arch Neurol, 61, 1416–20.CrossRefGoogle ScholarPubMed
Bhatia, KP, Bain, P, Bajaj, N et al. (2017). Consensus statement on the classification of tremors, from the task force on tremor of the International Parkinson and Movement Disorder Society. Mov Disord, 33, 75–87.CrossRefGoogle ScholarPubMed
Brin, MF, Lyons, KE, Doucette, J et al. (2001). A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor. Neurology, 56, 1523–8.Google Scholar
Fasano, A, Deuschl, G. (2015). Therapeutic advances in tremor. Mov Disord, 30, 1557–65.Google Scholar
Jankovic, J (2016). How do I examine for re-emergent tremor? Mov Disord Clin Pract, 3, 216–17.Google Scholar
Jankovic, J, Schwartz, K (1991). Botulinum toxin treatment of tremors. Neurology, 41, 1185–8.CrossRefGoogle ScholarPubMed
Jankovic, J, Schwartz, K, Clemence, W, Aswad, A, Mordaunt, J (1996). A randomized, double-blind, placebo-controlled study to evaluate botulinum toxin type A in essential hand tremor. Mov Disord, 11, 250–6.CrossRefGoogle ScholarPubMed
Jog, M, Lee, J, Scheschonka, A et al. (2020). Tolerability and efficacy of customized incobotulinumtoxinA injections for essential tremor: a randomized, double-blind, placebo-controlled study. Toxins, 12, 807.CrossRefGoogle ScholarPubMed
Lenka, A, Jankovic, J (2021). Tremor syndromes: an updated review. Front Neurol, 12, 684835.CrossRefGoogle ScholarPubMed
Mittal, SO, Jog, M, Lee, J, Jabbari, B (2020). Novel botulinum toxin injection protocols for Parkinson tremor and essential tremor – the Yale technique and sensor-based kinematics procedure for safe and effective treatment. Tremor Other Hyperkinet Mov, 10, 61.Google Scholar
Mittal, SO, Lenka, A, Jankovic, J (2019). Botulinum toxin for the treatment of tremor. Parkinsonism Relat Disord, 63, 31–41.CrossRefGoogle ScholarPubMed
Mittal, SO, Machado, D, Richardson, D, Dubey, D, Jabbari, B (2017). Botulinum toxin in Parkinson disease tremor. A randomized, double-blind, placebo-controlled study with a customized injection approach. Mayo Clin Proc, 92, 1359–67.Google ScholarPubMed
Mittal, SO, Machado, D, Richardson, D, Dubey, D, Jabbari, B (2018). Botulinum toxin in essential hand tremor – a randomized double-blind placebo-controlled study with customized injection approach. Parkinsonism Relat Disord, 56, 65–9.CrossRefGoogle ScholarPubMed
Pahwa, R, Busenbark, K, Swanson-Hyland, EF et al. (1995). Botulinum toxin treatment of essential head tremor. Neurology, 45, 822–4.CrossRefGoogle ScholarPubMed
Rahimi, F, Debicki, D, Roberts-South, A et al. (2015). Dynamic decomposition of motion in essential and parkinsonian tremor. Can J Neurol Sci, 42, 116–24.Google Scholar
Rajan, R, Srivastava, AK, Anandapadmanabhan, R et al. (2021). Assessment of botulinum neurotoxin injection for dystonic hand tremor: a randomized clinical trial. JAMA Neurology, 78, 302–11.CrossRefGoogle ScholarPubMed
Van Der Walt, A, Sung, S, Spelman, T et al. (2012). A double-blind, randomized, controlled study of botulinum toxin type A in MS-related tremor. Neurol, 79, 92–9.Google Scholar
Wissel, J, Masuhr, F, Schelosky, L, Ebersbach, G, Poewe, W (1997). Quantitative assessment of botulinum toxin treatment in 43 patients with head tremor. Mov Disord, 12, 722–6.CrossRefGoogle ScholarPubMed
Zesiewicz, TA, Elble, RJ, Louis, ED et al. (2011). Evidence-based guideline update: treatment of essential tremor: report of the Quality Standards subcommittee of the American Academy of Neurology. Neurology, 77, 1752–5.CrossRefGoogle Scholar

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