Safety of botulinum toxin for dysphagia in oculopharyngeal muscular dystrophy

• Published in: Muscle & nerve 2014-04, Vol.49 (4), p.601-603
• Main Authors: Youssof, Sarah, Schrader, Ronald M., Romero-Clark, Carol, Roy, Gulmohor, Spafford, Michael
• Format: Article
• Language: English
• Subjects: Aged; botulinum toxin; Botulinum Toxins - administration & dosage; Botulinum Toxins - adverse effects; Deglutition Disorders - drug therapy; Deglutition Disorders - epidemiology; Dysphagia; Dysphonia - chemically induced; Female; Humans; Male; Medical research; Middle Aged; Muscular dystrophy; Muscular Dystrophy, Oculopharyngeal - drug therapy; Muscular Dystrophy, Oculopharyngeal - epidemiology; neuromuscular diseases; oculopharyngeal muscular dystrophy; therapeutics; Treatment Outcome
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.24123

ABSTRACT Introduction: Despite multiple studies reporting marked benefit of botulinum toxin (BTX) for treatment of cricopharyngeal dysphagia, little is known about its safety for this indication. We examined the safety of cricopharyngeal BTX for dysphagia in oculopharyngeal muscular dystrophy (OPMD). Methods: We reviewed records of patients with OPMD who received cricopharyngeal BTX. Results: Twenty‐four patients underwent 66 procedures. Overall adverse event frequency was 44%. The most common adverse events were dysphonia (24%) and worsened dysphagia (14%). Logistic regression demonstrated that dose was a significant predictor of worsened dysphagia (P = 0.036) and of the composite event of dysphonia or worsened dysphagia (P = 0.009). There was a nonsignificant trend for dose as a predictor of dysphonia (P = 0.073). 59% of procedures were associated with symptomatic improvement. Conclusions: While BTX appears to be beneficial for treatment of dysphagia in OPMD, caution is warranted when injecting the cricopharyngeus muscle due to dose‐related risk of dysphonia or worsened dysphagia. Muscle Nerve 49:601–603, 2014