Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology

doi:10.1212/WNL.0000000000002560

Practice Guideline

. 2016 May 10;86(19):1818-26.

doi: 10.1212/WNL.0000000000002560. Epub 2016 Apr 18.

Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology

Affiliations

Affiliation

¹ From the Department of Neurology (D.M.S., M.W.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Motor Control Section (M.H.), National Institute of Neurological Disorders and Stroke (B.P.K.), National Institutes of Health, Bethesda, MD; Department of Neurology (E.J.A.), Bronson Neuroscience Center, Bronson Methodist Hospital, Kalamazoo, MI; Department of Neurological Sciences (C.L.C.), Rush University Medical Center, Chicago, IL; Department of Neurology (G.S.G.), University of Kansas School of Medicine, Kansas City; Department of Neurology (M.J.A.), University of Maryland, Baltimore; Department of Neurology (D.G.), Geisinger Health System, Danville, PA; Department of Neurology (S.P.), Kaiser Permanente Los Angeles Medical Center, CA; Parkinson's Disease Center and Movement Disorders Clinic (J.J.), Department of Neurology, Baylor College of Medicine, Houston, TX; Department of Neurology and Clinical Neurophysiology (M.N.), Klinikum Augsburg, Germany; Department of Neurology and Neurological Sciences (Y.T.S.), Stanford University, Palo Alto, CA; and Division of Physical Medicine and Rehabilitation (S.A.Y.), University of Alberta, Edmonton, Canada.

PMID: 27164716
PMCID: PMC4862245
DOI: 10.1212/WNL.0000000000002560

Practice Guideline

Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology

David M Simpson et al. Neurology. 2016.

. 2016 May 10;86(19):1818-26.

doi: 10.1212/WNL.0000000000002560. Epub 2016 Apr 18.

Affiliation

¹ From the Department of Neurology (D.M.S., M.W.G.), Icahn School of Medicine at Mount Sinai, New York, NY; Human Motor Control Section (M.H.), National Institute of Neurological Disorders and Stroke (B.P.K.), National Institutes of Health, Bethesda, MD; Department of Neurology (E.J.A.), Bronson Neuroscience Center, Bronson Methodist Hospital, Kalamazoo, MI; Department of Neurological Sciences (C.L.C.), Rush University Medical Center, Chicago, IL; Department of Neurology (G.S.G.), University of Kansas School of Medicine, Kansas City; Department of Neurology (M.J.A.), University of Maryland, Baltimore; Department of Neurology (D.G.), Geisinger Health System, Danville, PA; Department of Neurology (S.P.), Kaiser Permanente Los Angeles Medical Center, CA; Parkinson's Disease Center and Movement Disorders Clinic (J.J.), Department of Neurology, Baylor College of Medicine, Houston, TX; Department of Neurology and Clinical Neurophysiology (M.N.), Klinikum Augsburg, Germany; Department of Neurology and Neurological Sciences (Y.T.S.), Stanford University, Palo Alto, CA; and Division of Physical Medicine and Rehabilitation (S.A.Y.), University of Alberta, Edmonton, Canada.

PMID: 27164716
PMCID: PMC4862245
DOI: 10.1212/WNL.0000000000002560

Abstract

Objective: To update the 2008 American Academy of Neurology (AAN) guidelines regarding botulinum neurotoxin for blepharospasm, cervical dystonia (CD), headache, and adult spasticity.

Methods: We searched the literature for relevant articles and classified them using 2004 AAN criteria.

Results and recommendations: Blepharospasm: OnabotulinumtoxinA (onaBoNT-A) and incobotulinumtoxinA (incoBoNT-A) are probably effective and should be considered (Level B). AbobotulinumtoxinA (aboBoNT-A) is possibly effective and may be considered (Level C). CD: AboBoNT-A and rimabotulinumtoxinB (rimaBoNT-B) are established as effective and should be offered (Level A), and onaBoNT-A and incoBoNT-A are probably effective and should be considered (Level B). Adult spasticity: AboBoNT-A, incoBoNT-A, and onaBoNT-A are established as effective and should be offered (Level A), and rimaBoNT-B is probably effective and should be considered (Level B), for upper limb spasticity. AboBoNT-A and onaBoNT-A are established as effective and should be offered (Level A) for lower-limb spasticity. Headache: OnaBoNT-A is established as effective and should be offered to increase headache-free days (Level A) and is probably effective and should be considered to improve health-related quality of life (Level B) in chronic migraine. OnaBoNT-A is established as ineffective and should not be offered for episodic migraine (Level A) and is probably ineffective for chronic tension-type headaches (Level B).

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Dysphagia and Muscle Weakness Secondary to Botulinum Toxin Type A Treatment of Cervical Dystonia: A Drug Class Analysis of Prescribing Information.
Dashtipour K, Lee HS, Ellenbogen A, Kazerooni R, Gross TM, Hollander DA, Gallagher CJ. Dashtipour K, et al. Toxins (Basel). 2024 Oct 15;16(10):442. doi: 10.3390/toxins16100442. Toxins (Basel). 2024. PMID: 39453218 Free PMC article.
Efficacy and safety of onabotulinumtoxinA in the treatment of medication overuse headache: a systematic review.
Lang H, Peng C, Wu K, Chen X, Jiang X, He L, Chen N. Lang H, et al. Front Neurol. 2024 Sep 20;15:1453183. doi: 10.3389/fneur.2024.1453183. eCollection 2024. Front Neurol. 2024. PMID: 39372702 Free PMC article.
Do Diagnostic Nerve Blocks Affect the Starting Dose of Botulinum Neurotoxin Type A for Spasticity? A Case-Control Study.
Filippetti M, Tamburin S, Di Censo R, Aldegheri R, Mantovani E, Spina S, Battaglia M, Baricich A, Santamato A, Smania N, Picelli A. Filippetti M, et al. Toxins (Basel). 2024 Sep 6;16(9):388. doi: 10.3390/toxins16090388. Toxins (Basel). 2024. PMID: 39330846 Free PMC article.
Long-Term Management of Post-Stroke Spasticity with Botulinum Toxin: A Retrospective Study.
Falcone N, Leo F, Chisari C, Dalise S. Falcone N, et al. Toxins (Basel). 2024 Sep 3;16(9):383. doi: 10.3390/toxins16090383. Toxins (Basel). 2024. PMID: 39330841 Free PMC article.
Surgical reconstruction for spasticity and contracture: An underutilised rehabilitative strategy of adult stroke.
Chung MMT, Ip WY. Chung MMT, et al. JRSM Open. 2024 Sep 15;15(8):20542704241278544. doi: 10.1177/20542704241278544. eCollection 2024 Aug. JRSM Open. 2024. PMID: 39314623 Free PMC article. Review.

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References

1. Simpson M, Gracies JM, Graham HK, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum neurotoxin for the treatment of spasticity (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1691–1698. - PubMed
1. Simpson M, Blitzer A, Brashear A, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1699–1706. - PMC - PubMed
1. Naumann M, So Y, Argoff CE, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum toxin in the treatment of autonomic disorders and pain (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1707–1714. - PubMed
1. American Academy of Neurology. Clinical Practice Guidelines Process Manual, 2004 ed St. Paul, MN: The American Academy of Neurology; 2004. Available at: https://www.aan.com/Guidelines/Home/UnderDevelopment. Accessed August 1, 2011.
1. Jankovic J, Comella C, Hanschmann A, Grafe S. Efficacy and safety of incobotulinumtoxinA (NT 201, Xeomin) in the treatment of blepharospasm: a randomized trial. Mov Disord 2011;26:1521–1528. - PubMed

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[1] Simpson M, Gracies JM, Graham HK, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum neurotoxin for the treatment of spasticity (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1691–1698. - PubMed

[2] Simpson M, Gracies JM, Graham HK, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum neurotoxin for the treatment of spasticity (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1691–1698. - PubMed

[3] Simpson M, Blitzer A, Brashear A, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1699–1706. - PMC - PubMed

[4] Simpson M, Blitzer A, Brashear A, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1699–1706. - PMC - PubMed

[5] Naumann M, So Y, Argoff CE, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum toxin in the treatment of autonomic disorders and pain (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1707–1714. - PubMed

[6] Naumann M, So Y, Argoff CE, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum toxin in the treatment of autonomic disorders and pain (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1707–1714. - PubMed

[7] American Academy of Neurology. Clinical Practice Guidelines Process Manual, 2004 ed St. Paul, MN: The American Academy of Neurology; 2004. Available at: https://www.aan.com/Guidelines/Home/UnderDevelopment. Accessed August 1, 2011.

[8] American Academy of Neurology. Clinical Practice Guidelines Process Manual, 2004 ed St. Paul, MN: The American Academy of Neurology; 2004. Available at: https://www.aan.com/Guidelines/Home/UnderDevelopment. Accessed August 1, 2011.

[9] Jankovic J, Comella C, Hanschmann A, Grafe S. Efficacy and safety of incobotulinumtoxinA (NT 201, Xeomin) in the treatment of blepharospasm: a randomized trial. Mov Disord 2011;26:1521–1528. - PubMed

[10] Jankovic J, Comella C, Hanschmann A, Grafe S. Efficacy and safety of incobotulinumtoxinA (NT 201, Xeomin) in the treatment of blepharospasm: a randomized trial. Mov Disord 2011;26:1521–1528. - PubMed

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Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology

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Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology

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