Botulinum Toxin Is Effective in the Management of Neurogenic Dysphagia. Clinical-Electrophysiological Findings and Tips on Safety in Different Neurological Disorders

E. Alfonsi, D. A. Restivo, G. Cosentino, R. De Icco, G. Bertino, A. Schindler, M. Todisco, M. Fresia, A. Cortese, P. Prunetti, M. C. Ramusino, A. Moglia, G. Sandrini, C. Tassorelli

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15-20 U) into the CP muscle under electromyographic guidance. The patients were assessed at baseline and after the first and second treatment through clinical evaluation and fiberoptic endoscopy of swallowing, while their dysphagia was quantified using the Dysphagia Outcome and Severity Scale (DOSS). An electrokinesiographic/electromyographic study of swallowing was performed at baseline. Results: Most patients responded to the first BTX treatment: 35 patients (52.2%) were classified as high responders (DOSS score increase >2 levels), while other 19 patients (28.4%) were low responders (DOSS score increase of
Original languageEnglish
Pages (from-to)80
Number of pages1
JournalFrontiers in Pharmacology
Volume8
DOIs
Publication statusPublished - Feb 22 2017

Fingerprint

Botulinum Toxins
Deglutition Disorders
Nervous System Diseases
Safety
Upper Esophageal Sphincter
Deglutition
Muscles
Injections
Muscle Spasticity
Parkinsonian Disorders
Endoscopy
Brain Stem
Multiple Sclerosis
Therapeutics
Stroke

Keywords

  • botulinum toxin
  • cricopharyngeal muscle
  • electrophysiological study of swallowing
  • neurogenic dysphagia
  • upper esophageal sphincter dysmotility

Cite this

Botulinum Toxin Is Effective in the Management of Neurogenic Dysphagia. Clinical-Electrophysiological Findings and Tips on Safety in Different Neurological Disorders. / Alfonsi, E.; Restivo, D. A.; Cosentino, G.; Icco, R. De; Bertino, G.; Schindler, A.; Todisco, M.; Fresia, M.; Cortese, A.; Prunetti, P.; Ramusino, M. C.; Moglia, A.; Sandrini, G.; Tassorelli, C.

In: Frontiers in Pharmacology, Vol. 8, 22.02.2017, p. 80.

Research output: Contribution to journalArticle

Alfonsi, E. ; Restivo, D. A. ; Cosentino, G. ; Icco, R. De ; Bertino, G. ; Schindler, A. ; Todisco, M. ; Fresia, M. ; Cortese, A. ; Prunetti, P. ; Ramusino, M. C. ; Moglia, A. ; Sandrini, G. ; Tassorelli, C. / Botulinum Toxin Is Effective in the Management of Neurogenic Dysphagia. Clinical-Electrophysiological Findings and Tips on Safety in Different Neurological Disorders. In: Frontiers in Pharmacology. 2017 ; Vol. 8. pp. 80.
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abstract = "Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15-20 U) into the CP muscle under electromyographic guidance. The patients were assessed at baseline and after the first and second treatment through clinical evaluation and fiberoptic endoscopy of swallowing, while their dysphagia was quantified using the Dysphagia Outcome and Severity Scale (DOSS). An electrokinesiographic/electromyographic study of swallowing was performed at baseline. Results: Most patients responded to the first BTX treatment: 35 patients (52.2{\%}) were classified as high responders (DOSS score increase >2 levels), while other 19 patients (28.4{\%}) were low responders (DOSS score increase of",
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T1 - Botulinum Toxin Is Effective in the Management of Neurogenic Dysphagia. Clinical-Electrophysiological Findings and Tips on Safety in Different Neurological Disorders

AU - Alfonsi, E.

AU - Restivo, D. A.

AU - Cosentino, G.

AU - Icco, R. De

AU - Bertino, G.

AU - Schindler, A.

AU - Todisco, M.

AU - Fresia, M.

AU - Cortese, A.

AU - Prunetti, P.

AU - Ramusino, M. C.

AU - Moglia, A.

AU - Sandrini, G.

AU - Tassorelli, C.

N1 - LR: 20170816; JID: 101548923; OTO: NOTNLM; 2016/11/29 00:00 [received]; 2017/02/08 00:00 [accepted]; 2017/03/10 06:00 [entrez]; 2017/03/10 06:00 [pubmed]; 2017/03/10 06:01 [medline]; epublish

PY - 2017/2/22

Y1 - 2017/2/22

N2 - Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15-20 U) into the CP muscle under electromyographic guidance. The patients were assessed at baseline and after the first and second treatment through clinical evaluation and fiberoptic endoscopy of swallowing, while their dysphagia was quantified using the Dysphagia Outcome and Severity Scale (DOSS). An electrokinesiographic/electromyographic study of swallowing was performed at baseline. Results: Most patients responded to the first BTX treatment: 35 patients (52.2%) were classified as high responders (DOSS score increase >2 levels), while other 19 patients (28.4%) were low responders (DOSS score increase of

AB - Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15-20 U) into the CP muscle under electromyographic guidance. The patients were assessed at baseline and after the first and second treatment through clinical evaluation and fiberoptic endoscopy of swallowing, while their dysphagia was quantified using the Dysphagia Outcome and Severity Scale (DOSS). An electrokinesiographic/electromyographic study of swallowing was performed at baseline. Results: Most patients responded to the first BTX treatment: 35 patients (52.2%) were classified as high responders (DOSS score increase >2 levels), while other 19 patients (28.4%) were low responders (DOSS score increase of

KW - botulinum toxin

KW - cricopharyngeal muscle

KW - electrophysiological study of swallowing

KW - neurogenic dysphagia

KW - upper esophageal sphincter dysmotility

U2 - 10.3389/fphar.2017.00080 [doi]

DO - 10.3389/fphar.2017.00080 [doi]

M3 - Article

VL - 8

SP - 80

JO - Frontiers in Pharmacology

JF - Frontiers in Pharmacology

SN - 1663-9812

ER -