Treatment of phonic tics in patients with Tourette's syndrome using botulinum toxin type A

Neurol Sci. 2004 Feb;24(6):420-3. doi: 10.1007/s10072-003-0201-4.


We assessed the effect of botulinum toxin type A (BTX-A) on phonic tics in patients with Tourette's syndrome. A total of 30 patients received 2.5 IU BTX-A (BOTOX; Allergan) in both vocal cords. All patients were assessed after 15 days and then 4 times over a 12-month period. At each visit the following data were collected: phenomenology of tics, global impression of changes by physician and patient, number of BTX-A injections given, interval between injections, time to response, duration of response, presence of post-injection hypophonia and side effects, presence of premonitory sensory tic component, and interference with social life and work or school activities. Vocal tics improved after treatment in 93% patients, with 50% being tic-free. Mean response time was 5.8 days, and mean duration of response was 102 days. Quality of life improved, and premonitory experiences dropped from 53% to 20%. Hypophonia was the only side effect of note (80% of patients). BTX-A is an effective and safe treatment for phonic tics associated with Tourette's syndrome.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Aged
  • Botulinum Toxins, Type A / therapeutic use*
  • Child
  • Electromyography / drug effects
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neuromuscular Agents / therapeutic use*
  • Tics / classification
  • Tics / drug therapy*
  • Tics / etiology
  • Tourette Syndrome / complications
  • Treatment Outcome
  • Vocal Cords / drug effects


  • Neuromuscular Agents
  • Botulinum Toxins, Type A