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; Mark Hallett; Eric J. Ashman; Cynthia L. Comella; Mark W. Green; Gary S. Gronseth; Melissa J. Armstrong; David Gloss; Sonja Potrebic; Joseph Jankovic; Barbara P. Karp; Markus Naumann; Yuen T. So; Stuart A. Yablon

doi:10.1212/WNL.0000000000002560

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, Mark Hallett, Eric J. Ashman, Cynthia L. Comella, Mark W. Green, Gary S. Gronseth, Melissa J. Armstrong, David Gloss, Sonja Potrebic, Joseph Jankovic, Barbara P. Karp, Markus Naumann, Yuen T. So, Stuart A. Yablon

Research output: Contribution to journal › Article › peer-review

339 Scopus citations

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).

Original language	English
Pages (from-to)	1818-1826
Number of pages	9
Journal	Neurology
Volume	86
Issue number	19
DOIs	https://doi.org/10.1212/WNL.0000000000002560
State	Published - 10 May 2016

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Simpson, D. M., Hallett, M., Ashman, E. J., Comella, C. L., Green, M. W., Gronseth, G. S., Armstrong, M. J., Gloss, D., Potrebic, S., Jankovic, J., Karp, B. P., Naumann, M., So, Y. T., & Yablon, S. A. (2016). 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. Neurology, 86(19), 1818-1826. https://doi.org/10.1212/WNL.0000000000002560

@article{22b1c20ba31346fb9672b656f14fec1e,

title = "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",

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).",

author = "Simpson, {David M.} and Mark Hallett and Ashman, {Eric J.} and Comella, {Cynthia L.} and Green, {Mark W.} and Gronseth, {Gary S.} and Armstrong, {Melissa J.} and David Gloss and Sonja Potrebic and Joseph Jankovic and Karp, {Barbara P.} and Markus Naumann and So, {Yuen T.} and Yablon, {Stuart A.}",

note = "Funding Information: Financial support from the American Academy of Neurology. Authors who serve as AAN subcommittee members or methodologists (E.J.A., G.S.G., M.J.A., D.G., S.P.) were reimbursed by the AAN for expenses related to travel to subcommittee meetings where drafts of manuscripts were reviewed. Publisher Copyright: {\textcopyright} 2016 American Academy of Neurology.",

year = "2016",

month = may,

day = "10",

doi = "10.1212/WNL.0000000000002560",

language = "English",

volume = "86",

pages = "1818--1826",

journal = "Neurology",

issn = "0028-3878",

publisher = "Lippincott Williams and Wilkins Ltd.",

number = "19",

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Simpson, DM, Hallett, M, Ashman, EJ, Comella, CL, Green, MW, Gronseth, GS, Armstrong, MJ, Gloss, D, Potrebic, S, Jankovic, J, Karp, BP, Naumann, M, So, YT & Yablon, SA 2016, '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', Neurology, vol. 86, no. 19, pp. 1818-1826. https://doi.org/10.1212/WNL.0000000000002560

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. / Simpson, David M.; Hallett, Mark; Ashman, Eric J. et al.

In: Neurology, Vol. 86, No. 19, 10.05.2016, p. 1818-1826.

Research output: Contribution to journal › Article › peer-review

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T2 - 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

AU - Simpson, David M.

AU - Hallett, Mark

AU - Ashman, Eric J.

AU - Comella, Cynthia L.

AU - Green, Mark W.

AU - Gronseth, Gary S.

AU - Armstrong, Melissa J.

AU - Gloss, David

AU - Potrebic, Sonja

AU - Jankovic, Joseph

AU - Karp, Barbara P.

AU - Naumann, Markus

AU - So, Yuen T.

AU - Yablon, Stuart A.

N1 - Funding Information: Financial support from the American Academy of Neurology. Authors who serve as AAN subcommittee members or methodologists (E.J.A., G.S.G., M.J.A., D.G., S.P.) were reimbursed by the AAN for expenses related to travel to subcommittee meetings where drafts of manuscripts were reviewed. Publisher Copyright: © 2016 American Academy of Neurology.

PY - 2016/5/10

Y1 - 2016/5/10

N2 - 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).

AB - 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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Simpson DM, Hallett M, Ashman EJ, Comella CL, Green MW, Gronseth GS et al. 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. Neurology. 2016 May 10;86(19):1818-1826. doi: 10.1212/WNL.0000000000002560