Lambert, F. (Franka) (2018) Botulinum neurotoxin treatment effects last in patients with a Functional Movement Disorder. thesis, Medicine.
Full text available on request.Abstract
Background Functional movement disorders (FMD) are genuine movement disorders that lack an identifiable pathologic substrate. FMD is present in a large proportion of patients referred to a neurologist. It has a poor prognosis, while at the same time it causes a lot of disability. The treatment options are scarce and not studied extensively. The BoNT trial showed that patients have a potential to improve when treated with Botulinum neurotoxin even when they have had a long duration of symptoms. However, the effect was probably largely due to placebo result. We set out to see whether this effect lasted and if there was improvement in other areas. Methods A follow up study of the BoNT trial was performed in the Academic Medical Centre, Amsterdam, The Netherlands. Patients, who had participated in the BoNT trial, were interviewed via telephone and asked to fill in a questionnaire via mail. We assessed symptom severity, physical functioning, work status, psychiatric symptoms, additional treatments and development of other functional neurological symptoms. Motor symptom severity was assessed using the self-reported Clinical Global Impression-Severity (CGI-S) and the Clinical Global Impression-Improvement scale (CGI-I). Results We included 48 patients in this study, of which 10 still received Botulinum neurotoxin injections. Median time since inclusion was 57 months. In 66% of patients the beneficial effect of treatment lasted or further improvement occurred on the CGI-I since injections had been discontinued. Patients showed a significant improvement in CGI-S scores after receiving Botulinum neurotoxin injections compared to the start of the study (p = 0,002). There was no difference in motor symptom severity between patients still receiving Botulinum neurotoxin injections and those who were not (p = 0,542). Conclusion The effect of treatment during the BoNT study, lasted even after treatment cessation. No additional effect was found in patients who continued treatment with BoNT after the study ended.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Koning-Tijssen, Prof M.A.J. de and UMCG, Groningen Afdeling Neurologie |
| Supervisor name: | Tweede begeleider: and Dreissen Y.E.M. arts-onderzoeker/AIOS neurologie and AMC, Amsterdam Afdeling: Neurologie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1334 |
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