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Botolinum Toxin A in a 33-year old Multigravid Filipino with Dystonia Gravidarum: A Case Report

G. Vista, J. Vatanagul, K. Sia (Cebu, Philippines)

Meeting: MDS Virtual Congress 2020

Abstract Number: 121

Keywords: Botulinum toxin: Clinical applications: dystonia, Dystonia: Treatment

Category: Dystonia: Clinical Trials and Therapy

Objective: This paper aims to present a rare case of dystonia gravidarum using Botolinum Toxin A as treatment.

Background: Dystonia is a rare event in pregnancy. This is the first case of dystonia gravidarum to be documented in the Philippines and the fourth case in the world after extensive literature review. This is the first documented case of dystonia gravidarum to occur in a multigravida and in the second trimester. Botolinum Toxin A injection is a treatment option for dystonia gravidarum. 

This is a case of a 33-year-old multigravid Filipino at 15 weeks age of gestation (AOG) who sought consult for complaints of upper back spasms which progressed to left laterocollis, vocal tremors, shoulder elevations. Patient was initially given Zolpidem and Biperidin. Due to failure of response to treatment, Botolinum Toxin A was injected to the affected muscle groups as an alternative treatment which provided temporary relief. There was good fetal outcome and complete resolution of symptoms during the postpartum period without additional Botolinum Toxin A injections.

Method: Case report

Results: not applicable

Conclusion: This is the first case of dystonia gravidarum to be documented in the Philippines and the fourth case in the world after extensive literature review. Botilunum Toxin A injection is an alternative treatment modality for Dystonia Gravidarum.

References: 1. Comella, C. et.al (2018) Classification and evaluation of dystonia. UpToDate. Retrieved on Feb 21, 2020, from https://www.uptodate.com/contents/classification-and-evaluation-of-dystonia?search=dsytonia&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H1 2. Kranick, S. M., Mowry, E. M., Colcher, A., Horn, S., & Golbe, L. I. (2010). Movement disorders and pregnancy: A review of the literature. Movement Disorders, 25(6), 665–671. doi:10.1002/mds.23071 3. Lim, E. C.-H., Seet, R. C.-S., Wilder-Smith, E. P. V., & Ong, B. K.-C. (2006). Dystonia Gravidarum: A new entity? Movement Disorders, 21(1), 69–70. doi:10.1002/mds.20648 4. Fasano, A., Elia, A. E., Guidubaldi, A., Tonali, P. A., & Bentivoglio, A. R. (2007). Dystonia Gravidarum: A new case with a long follow-up. Movement Disorders, 22(4), 564–566. doi:10.1002/mds.21310 5. Buccoliero, R., Palmeri, S., Malandrini, A., Dotti, M. T., & Federico, A. (2007). A case of dystonia with onset during pregnancy. Journal of the Neurological Sciences, 260(1-2), 265–266. doi:10.1016/j.jns.2007.04.008 6. Löscher, W., Blanke, T., Richter, A., & Hoppen, H.-O. (1995). Gonadal sex hormones and dystonia: Experimental studies in genetically dystonic hamsters. Movement Disorders, 10(1), 92–102. doi:10.1002/mds.870100115 7. Comella, C. et.al (2019). Treatment of dystonia Retrieved on Feb 21, 2020, from https://www.uptodate.com/contents/treatment-of dystonia?search=benzodiazepines%20for%20dystonia&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H4 8. Brin, M. F., Kirby, R. S., Slavotinek, A., Miller-Messana, M. A., Parker, L., Yushmanova, I., & Yang, H. (2015). Pregnancy outcomes following exposure to onabotulinumtoxinA. Pharmacoepidemiology and Drug Safety, 25(2), 179–187. doi:10.1002/pds.3920

To cite this abstract in AMA style:

G. Vista, J. Vatanagul, K. Sia. Botolinum Toxin A in a 33-year old Multigravid Filipino with Dystonia Gravidarum: A Case Report [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/botolinum-toxin-a-in-a-33-year-old-multigravid-filipino-with-dystonia-gravidarum-a-case-report/. Accessed June 15, 2025.
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