Botulinum toxin (BTX)
injections provide effective treatment for a variety of disorders manifested by inappropriate muscle contractions, but its efficacy in the treatment of
tics has not been previously studied. Ten male patients 13-53 years of age who were diagnosed with
Tourette's syndrome manifested by disabling focal
tics were included in this pilot study. Five patients had frequent blinking and
blepharospasm, rendering them "blind," and five patients had severe and painful dystonic
tics involving their neck muscles. All 10 patients experienced moderate to marked improvement in the intensity and frequency of
tics after BTX
injections into the involved muscles. Patients in whom premonitory urges preceded their
tics noted marked lessening of these sensory symptoms. The benefit lasted 2-20 weeks after
injections. There were no serious complications, except for transient ptosis in two and
neck pain, stiffness, or weakness in three patients. BTX
injections appear to be safe and effective treatment for patients with focal dystonic
tics. The treatment ameliorates not only
involuntary movements but also the premonitory sensory component associated with some
tics.