Uses of botulinum toxin in the management of patients with movement disorders: a national survey from India

Objective: The aim was to assess the opinion of the movement disorder society of India members regarding the uses of botulinum toxin in clinical practice. Methods: We developed an online questionnaire covering different aspects of botulinum toxin uses. The questionnaire was sent by email to all members of the movement disorder society of India. Results: A total of 50 members completed the survey (20%) representing different regions of the country. The average doses of botulinum toxin conform to those mentioned in the literature. Only type A botulinum toxin is available in India. Electromyography was used by 72% of the respondents, however, only 12% of respondents used ultrasonography for muscle localization during botulinum toxin injection. 72% of respondents were using an assessment scale for different types of movement disorders. 76% of the respondents reported adverse effects in their clinical practice, with weakness (69.11%) being the most common. 56% of the respondents reported challenges during the injections with the cost of botulinum toxin being the most common (36%) followed by difficulty in localization of muscles (30%). Conclusion: Our results seem to show that in India, the routine use of botulinum toxin in clinics is far from standardized. Low uses of USG, difficulty in muscle localization and cost of the toxin were important limitations highlighted by the respondents.