Objective: To study the effects of botulinum neurotoxin (BTX) treatment on gait characteristics in patients with blepharospasm and cervical dystonia.

Background: The impact of focal dystonia on gait has attracted little attention and remains elusive. Considering the importance of both visual control and head posture control in gait, we hypothesized that blepharospasm and cervical dystonia should affect gait and that improvement of cervical/eyelid control brought about by BTX injections should translate into improvement of gait characteristics.

Method: Eight patients with blepharospasm, 10 patients with cervical dystonia and healthy, age- and gender matched control subjects were included. Gait was assessed twice, before and one month after BTX injections, on a Biodex Gait Trainer^TM 3. Gait velocity, cadence, step length, as well as asymmetry and variability of step length were compared between patients and controls, and, in the patients, between before and after BTX, using non-parametric statistics.

Results: At baseline, in patients with blepharospasm, gait velocity and step length were significantly smaller than in controls (p<0.02 and 0.03, respectively), with a trend for step length variability to be greater (p=0.058). One month after BTX, gait velocity, step length were significantly increased, and variability decreased (ps<0.02). In patients with cervical dystonia, gait velocity, step length and cadence were reduced at baseline compared to controls (ps<0.01). After BTX, gait velocity and step length were increased (p<0.01) while step length variability was reduced (p<0.05).

Conclusion: Patients with focal dystonia not affecting lower limbs present with gait abnormalities that are improved by BTX treatment. Our findings support the interest of a holistic assessment and treatment in patients with focal dystonia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-botulinum-toxin-treatment-on-gait-in-focal-dystonia/