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Indian Journal of Obstetrics and Gynecology Research


Sub-therapeutic use of botulinum toxin in cervical dystonia, blepharospasm, hemifacialspasm and post herpetic neuralgia during pregnancy : A prospective study


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Author Details : Meena Jain, Shailendra Jain*

Volume : 7, Issue : 1, Year : 2020

Article Page : 100-103


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Abstract

Introduction: We aimed to study sub therapeutic (to reduce intensity of discomfort) and safe dose
administration of BoTn/A in certain dystonic neurological movement disorders and Post herpetic Neuralgia
(PHN) during pregnancy.
Materials and Methods: Total 7 cases studied [(Cervical dystonia =1), (Blepharospasm =2), (Hemi facial
spasm=1) and (PHN=3)].
BoTn/A (dysport – SPEYWOOD) was diluted in 10 ml of normal saline. Arbitrary 200 to 500 units was
administerd depending upon clinical assessment. The patients followed at 1, 3, 4, 12 and 16 weeks. The
fetal well being was assessed after delivery and maximum follow-up to 1 and half year period.
Botulinum toxin type a is used as a therapeutic agent in various hyper active movement disorders such
as cervical dystonia, blepharospasm, hemi facial spasm and intractable neuropathic pain such as post
herpetic neuralgia (PHN). 1 It is an exotoxin produced by clostridium botulinum. It prevents the release
of acetylcholine thereby preventing the muscle contraction and reducing pain transmission.
Result: The mean age was 35 years. The severity of spasm assessed on intensity, range and frequency of
contraction of muscles. In PHN pain intensity measured on VAS score. There was a significant subjective
improvement in the spasm in cervical dystonia, blepharo spasm, & hemifacial spasm. The VAS score
reduced significantly in all three cases. The fetuses born were healthy and no congenital malformation
observed. The children were followed by an average one year were found healthy.
Conclusion: We observed that BoTn/A decreased subjective discomfort in Dystonia, spasm and in the
intensity of neuropathic pain. It is safer to administer during pregnancy particularly in third trimester as the
fetus born were healthy. The oral medications such as antiepileptic are not without side effects. Therefore,
we conclude that it is safer to administer during pregnancy particularly in third trimester. However, larger
study is needed.

Keywords: Botulinum toxin, Cervical dystonia, Blepharospasm, Hemi facial spasm, Pregnancy, Post herpetic neuralgia.

Doi : 10.18231/j.ijogr.2020.020

How to cite : Jain M, Jain S, Sub-therapeutic use of botulinum toxin in cervical dystonia, blepharospasm, hemifacialspasm and post herpetic neuralgia during pregnancy : A prospective study. Indian J Obstet Gynecol Res 2020;7(1):100-103

Copyright © 2020 by author(s) and Indian J Obstet Gynecol Res. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (creativecommons.org)