Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Practice Guideline
. 2016 May 10;86(19):1818-26.
doi: 10.1212/WNL.0000000000002560. Epub 2016 Apr 18.

Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache [RETIRED]: Report of the Guideline Development Subcommittee of the American Academy of Neurology

David M Simpson  1 , Mark Hallett  1 , Eric J Ashman  1 , Cynthia L Comella  1 , Mark W Green  1 , Gary S Gronseth  1 , Melissa J Armstrong  1 , David Gloss  1 , Sonja Potrebic  1 , Joseph Jankovic  1 , Barbara P Karp  1 , Markus Naumann  1 , Yuen T So  1 , Stuart A Yablon  1
Affiliations
Practice Guideline

Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache [RETIRED]: Report of the Guideline Development Subcommittee of the American Academy of Neurology

David M Simpson et al. 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).

PubMed Disclaimer

References

    1. Simpson M, Gracies JM, Graham HK, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum neurotoxin for the treatment of spasticity (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1691–1698. - PubMed
    1. Simpson M, Blitzer A, Brashear A, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1699–1706. - PMC - PubMed
    1. Naumann M, So Y, Argoff CE, et al. ; for the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: botulinum toxin in the treatment of autonomic disorders and pain (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1707–1714. - PubMed
    1. American Academy of Neurology. Clinical Practice Guidelines Process Manual, 2004 ed St. Paul, MN: The American Academy of Neurology; 2004. Available at: https://www.aan.com/Guidelines/Home/UnderDevelopment. Accessed August 1, 2011.
    1. Jankovic J, Comella C, Hanschmann A, Grafe S. Efficacy and safety of incobotulinumtoxinA (NT 201, Xeomin) in the treatment of blepharospasm: a randomized trial. Mov Disord 2011;26:1521–1528. - PubMed

Publication types

MeSH terms