Effect of Botulinum Toxin on Resting Tremor of the Refractory Upper Limb in Parkinsonians

Other illness

• Patients with atypical parkinsonian syndrome;
• patients with a urinary tract infection at the time of treatment if the patient suffers from urinary incontinence due to neurological detrusor overactivity
• patients with a history of swallowing or respiratory disorders;

Lab values

• Patients treated with drugs which have the adverse effect of causing the appearance or aggravation of tremors: lithium, sodium valproate, levetiracetam, benzodiazepines, corticosteroids, thyroid hormones, ciclosporin, alcohol, tricyclic antidepressants, theophillyne, terbutaline, antipsychotics (excluding clozapine) ;
• Patients with hypersensitivity to the active substance or to one of the excipients (human albumin, lactulose);

Age

• Women of childbearing age without effective contraception;

Other

• Patients with tremors related to a pathology other than PD;
• patients with atrophy of the target muscle
• patients with marked clinical or subclinical neuromuscular transmission deficits (e.g., myasthenia gravis);
• patients with fixed contractures Pregnant or breastfeeding women;
• Patients under legal guardianship, tutorship, or curatorship.

• Patients with PD defined according to UKPDSBB criteria;
• Men and women aged between 40 and 80 years;
• Patients with troublesome rest tremor assessed by the CGI-S scale ≥ 3 and persistent despite the initiation of ≥ two anti-parkinsonian treatments (levodopa, dopaminergic agonist, anticholinergic), which defines drug-resistant parkinsonian tremor;
• Patients naïve to botulinum toxin treatment;
• Patients whose antiparkinsonian treatment has been stable for at least 4 weeks prior to inclusion and for the duration of the study;
• Person affiliated with or beneficiary of a social security scheme;
• Free, informed, and written consent signed by the participant and the investigator (no later than the day of inclusion and before any examination required by the research).