Objective: To explore the effect of postponement of BoNT injections on symptoms and quality of life (QoL) in patients with CD during COVID-19 related lockdowns.
Background: The COVID-19 pandemic has led to temporally lockdowns and postponements of botulinum toxin injections (BoNT) in patients with cervical dystonia (CD). The impact of this situation in Asian CD has never been explored.
Method: CD patients who required regular BoNT injections and whose appointments had been postponed for at least 28 days due to the COVID-pandemic were recruited from our clinic. Eight conceptual domains of The Cervical Dystonia Impact Profile (CDIP) including QoL, head and neck symptoms, neck pain, sleep, upper limb function and psychosocial aspects were evaluated by phone. Outcomes were classified into worse, stable and better in each category.
Results: 24 CD patients (12 females) with a mean disease duration of 9.7 ± 7.7 years who have been receiving BoNT injections consecutively for 15.7 ± 10.1 times and for a mean duration of 5.2 ± 3.0 years completed the questionnaire (Table 1). The mean duration of postponement due to lockdown was 47.08 ± 28.7 days. More than half of patients reported reduced QoL with worsening of head and neck symptoms, increased pain and annoyance (Fig1). Deterioration of QoL and head & neck symptoms were significantly higher in patients who had received BoNT more than 15 times compared to those who received less than 15 times (both, p=0.01). Patients suggested that the delayed BoNT injections could be 42.6 ± 28.5 days if further lockdown occurs.
Conclusion: Our study demonstrated that delayed regular BoNT injections due to COVID-19 related lockdowns reduced quality of life and cause worsening of symptoms in cervical dystonia. Patients with long-term injections should be carefully monitored for significant symptom deterioration if BoNT sessions are postponed.
To cite this abstract in AMA style:
P. Wongwan, P. Panyakaew, R. Bhidayasiri. The impact of lockdown due to the COVID-19 pandemic on Asian cervical dystonia patients treated with Botulinum toxin injections [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/the-impact-of-lockdown-due-to-the-covid-19-pandemic-on-asian-cervical-dystonia-patients-treated-with-botulinum-toxin-injections/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-impact-of-lockdown-due-to-the-covid-19-pandemic-on-asian-cervical-dystonia-patients-treated-with-botulinum-toxin-injections/