A survey about the accessibility to botulinum toxin therapy for dystonia

: We investigated the accessibility of the therapy with botulinum toxin for blepharospasm or cervical dystonia in Japan. Based on the administration sheet for Botox sent to the Japan Branch of Allergan Co. Ltd. (Tokyo, Japan), the survey was performed about how many institutions treated 3 or more patients with botulinum toxin in each of February, 2003, and February, 2005, for each disease entity. Among 369 secondary medical zones covering all the areas of Japan, 73 zones had 103 institutions that met our criteria for blepharospasm in 2003, and the number slightly increased to 77 zones and 109 institutions in 2005. For cervical dystonia, 25 zones had 32 institutions in 2003, and the number increased to 36 zones and 48 institutions in 2005. Although medical zones with larger population tended to have more institutions, there was great inequality in the accessibility of patients among medical zones. Besides, the number of institutions was thought to be quite insufficient especially for cervical dystonia in most areas of Japan. Larger number of institutions in any region of Japan should be preferably able to treat focal dystonia with botulinum toxin in order to improve patients' accessibility, because this safe and effective therapy can be now regarded as the first line for both blepharospasm and cervical dystonia.