Botulinum Toxin for the Treatment of Tremor and Tics

Mitesh Lotia, MD; Joseph Jankovic, MD

Disclosures

Semin Neurol. 2016;36(1):54-63. 

In This Article

Abstract and Introduction

Abstract

The therapeutic applications of botulinum toxin (BoNT) have grown manifold since its initial approval in 1989 by the U.S. Food and Drug Administration for the treatment of strabismus, blepharospasm, and other facial spasms. Although it is the most potent biologic toxin known to man, long-term studies have established its safety in the treatment of a variety of neurologic and nonneurologic disorders. Despite a paucity of randomized controlled trials, BoNT has been found to be beneficial in treating a variety of tremors and tics when used by clinicians skilled in the administration of the drug for these hyperkinetic movement disorders. Botulinum toxin injections can provide meaningful improvement in patients with localized tremors and tics; in some cases, they may be an alternative to other treatments with more undesirable adverse effects.

Introduction

Therapeutic application of botulinum toxin (BoNT), the most potent muscle relaxant, has markedly expanded since December of 1989 when it was first approved by the U.S. Food and Drug Administration (FDA) for the treatment of strabismus, blepharospasm, and other facial nerve disorders, including hemifacial spasm. Its long-term efficacy and safety in dystonia and other movement and neurologic disorders have been well established.[1,2] In this review, we will focus on the use of BoNT in the treatment of tremors and tics.

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