Safety of botulinum toxin for dysphagia in oculopharyngeal muscular dystrophy

Despite multiple studies reporting marked benefit of botulinum toxin (BTX) for treatment of cricopharyngeal dysphagia, little is known about its safety for this indication. We examined the safety of cricopharyngeal BTX for dysphagia in oculopharyngeal muscular dystrophy (OPMD). We reviewed records of patients with OPMD who received cricopharyngeal BTX. Twenty-four patients underwent 66 procedures. Overall adverse event frequency was 44%. The most common adverse events were dysphonia (24%) and worsened dysphagia (14%). Logistic regression demonstrated that dose was a significant predictor of worsened dysphagia (P=0.036) and of the composite event of dysphonia or worsened dysphagia (P=0.009). There was a non-significant trend for dose as a predictor of dysphonia (P=0.073). 59% of procedures were associated with symptomatic improvement. While BTX appears to be beneficial for treatment of dysphagia in OPMD, caution is warranted when injecting the cricopharyngeus muscle due to dose-related risk of dysphonia or worsened dysphagia.This project was supported in part by the Muscular Dystrophy Association (Clinical Research Training Grant) and the NIH/NCRR/NCATS (University of New Mexico Clinical and Translational Science Center, 8UL1TR000041). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.Biomedical SciencesMastersUniversity of New Mexico. Biomedical Sciences Graduate ProgramMorrison, LeslieBear, DavidSchuyler, Mar