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J Neurol Sci. 2017 Sep 15;380:142-147. doi: 10.1016/j.jns.2017.07.031. Epub 2017 Jul 24.

Botulinum toxin alleviates dysphagia of patients with inclusion body myositis.

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland. Electronic address: aleksi.schrey@tyks.fi.
2
Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland.
3
Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland.

Abstract

OBJECTIVES:

Oropharyngeal dysphagia is a disabling and undertreated symptom that often occurs in patients with sporadic inclusion body myositis (s-IBM). In this study, we examined the effect of botulinum neurotoxin A (BoNT-A) injections to the cricopharyngeus muscle (CPM) of patients with s-IBM and dysphagia.

PATIENTS, MATERIALS AND METHODS:

A single-center retrospective study involving 40 biopsy-proven s-IBM-patients treated in the District of Southwest Finland from 2000 to 2013. The incidence of dysphagia, rate of aspirations, rate of aspiration pneumonias and treatment results of dysphagia were analyzed. Patients treated for dysphagia were evaluated before and after surgery by video-fluoroscopy and/or using a questionnaire.

RESULTS:

Twenty-five of the 40 s-IBM patients (62.5%) experienced dysphagia. BoNT-A was injected a median of 2 times (range 1-7) in 12 patients with dysphagia. Before the injections 7 patients reported aspiration, none afterwards. The corresponding figures for aspiration pneumonia were 3 and 0. All of these patients had normal swallowing function 12months (median, range 2-60) after the last injection.

CONCLUSION:

BoNT-A injections to the CPM alleviate the dysphagia of s-IBM patients reversibly and appear to reduce the rate of aspiration effectively.

KEYWORDS:

Botulinum neurotoxin; Cricopharyngeus muscle; Dysphagia; Endoscopy; Inclusion body myositis; Reversible

PMID:
28870555
DOI:
10.1016/j.jns.2017.07.031
[Indexed for MEDLINE]

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