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We treated focal hand dystonia in 53 patients with botulinum toxin injections for up to 6 years.Eighty-one percent of the patients improved with at least one injection session.Sixty-five percent of the injections produced transient weakness.We followed 37 of the patients for at least 2 years from the start of treatment,24 of whom discontinued treatment because of inadequate response,loss of response,inaccessibility of a treatment provider,or the expense of the toxin.Women,who had a greater extend and longer duration of benefit than men,were more likely to continue treatment.The mean interval between injection sessions was 6 months.In most patients,we injected the toxin into the same combination of muscles at each session.The dose of toxin generally fluctuated within a range of 20 units.Side effects were mild and transient and unrelated to the long-term use of botulinum toxin.Botulinum toxin injection is safe and effective for the long-term management of focal hand dystonia. |
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