A focal dystonia can result in disability. Local injection of botulinum toxin may be followed by a favorable response which can be graded based on the scales of Gupta et al.
Parameters:
(1) disability rating scale (modified after Jancovic et al)
(2) maximal benefit (peak effect) after botulinum toxin injection
(3) side effects of botulinum toxin injection
(4) global rating scale
|
Severity of Spasm |
Disability |
Grade |
|
none |
none |
0 |
|
slight (barely noticeable) |
none |
1 |
|
mild |
none to slight |
2 |
|
moderate |
mild to moderate |
3 |
|
severe |
incapacitating |
4 |
where:
• The modification of the scale of Jancovic et al was to add slight and mild to the disability column (before the levels were none, moderate and incapacitating).
|
Maximal Benefit After Injection (Peak Effect) |
Functional Improvement |
Grade |
|
no effect |
no change in function |
0 |
|
mild improvement |
no change in function |
1 |
|
moderate improvement |
no change in function |
2 |
|
moderate improvement |
moderate improvement |
3 |
|
marked improvement |
marked improvement |
4 |
|
Side Effect |
Grade |
|
none |
0 |
|
mild |
1 |
|
disabling |
2 |
global rating score =
= (grade of maximal benefit) - (grade of side effect)
Interpretation:
• A global rating scale >= 2 was considered a favorable response to local injection with botulinum toxin.
Purpose: To grade the disability associated with a focal dystonia and the response to local botulinum injections.
Specialty: Sports Medicine & Rehabilitation, Neurology
Objective: disability and performance
ICD-10: G24,
