EFFICACY OF BOTULINUM TOXIN FOR CERVICAL DYSTONIA - A COMPARISON OF METHODS FOR EVALUATION

Twenty patients with cervical dystonia were treated during one year wi th repeated intramuscular injections of botulinum toxin, The outcome w as evaluated comparing subjective global rating with relative changes in degree of pain on the Visual analogue scale (VAS), degree of dysfun ction due to dystonia, and quality of life according to the Nottingham health profile (NHP). Objective measurement of dystonic position and movement ability was performed using a goniometer, semiquantitatively noted as scores according to Fahn and Tsui, Before treatment, the degr ee of impaired life quality on the NHP did not correlate with the Tsui score of dystonic posture, but significantly with the Fahn score (p < 0.01) which also includes data on pain, Significant improvement after treatment was seen for all parameters(p < 0.05), Global subjective ra ting correlated significantly with improved posture according to the T sui score (p < 0.05), but not with reduced pain or degree of dysfuncti on. The results suggest that the efficacy of botulinum toxin in cervic al dystonia is best evaluated using a combination of the VAS for pain and the Tsui score for dystonic posture and movement ability.