A focal dystonia can result in disability. Local injection of botulinum toxin may be followed by a favorable response which can be graded based on the scales of Gupta et al.
(1) disability rating scale (modified after Jancovic et al)
(2) maximal benefit (peak effect) after botulinum toxin injection
(3) side effects of botulinum toxin injection
(4) global rating scale
Severity of Spasm
slight (barely noticeable)
none to slight
mild to moderate
• The modification of the scale of Jancovic et al was to add slight and mild to the disability column (before the levels were none, moderate and incapacitating).
Maximal Benefit After Injection (Peak Effect)
no change in function
global rating score =
= (grade of maximal benefit) - (grade of side effect)
• A global rating scale >= 2 was considered a favorable response to local injection with botulinum toxin.
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Purpose: To grade the disability associated with a focal dystonia and the response to local botulinum injections.
Specialty: Sports Medicine & Rehabilitation, Neurology
Objective: disability and performance