Publications (2)1.36 Total impact
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Article: Nachweis von Botulinum-Toxin-Antikörper
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ABSTRACT: HintergrundEin Teil der mit Botulinum-Toxin (Btx) behandelten Patienten bilden neutralisierende Antikörper (Btx-Ak). Als Goldstandard zum Nachweis dieser gilt das Mouse Diaphragma Bioassay (MDB). Wir prüften, ob der preislich günstigere Extensor-digitorum-brevis-Test (EDB-Test) diesen ersetzten kann. Material und MethodeEine Elektroneurographie (ENG) des M. extensor digitorum brevis wurde an 23 Patienten mit bekanntem MDB beidseits durchgeführt. Danach wurde in den rechten Fuß 25Units Btx injiziert. 21–28Tage später folgte die ENG-Kontrolle. Die Werte Latenz zwischen Stimulation und muskulärem Antwortpotenzial (dLAT), Höhe des muskulären Antwortpotenzials (AMP), „area under the curve“ (Fläche) und Dauer (DAU) beider Visiten wurden intraindividuell und mit dem MDB verglichen. ErgebnisseFläche und AMP korrelierten hoch signifikant mit dem MDB (p jeweils <0,001). Die Abnahme der AMP auf mindestens 65% spricht gegen vorhandene Btx-Ak. Dabei wurden 22 der 23 Patienten wie im MDB eingestuft. Die Sensitivität war 92,86%, die Spezifität 100%. SchlussfolgerungDer EDB-Test ist zuverlässig und hat eine hohe Sensitivität sowie Spezifität. Im klinischen Alltag kann der EDB-Test das MDB ersetzen. IntroductionSome patients treated with botulinum toxin (btx) develop neutralizing btx antibodies (btx-ab). The expensive Mouse Diaphragm Bioassay (MDB) is considered as the gold standard by many authors. We wanted to examine whether the Extensor Digitorum Brevis Test (EDB test) is a reliable method to test for btx-ab. MethodWe performed an electroneurography of the m. extensor digitorum brevis on both feet of 23 patients with known MDB. Afterwards the right feet were injected with 25U of btx, and 21–28days later the electroneurography was performed on both sides again. Finally we correlated the measured values (muscular wave latency, amplitude, area, and duration) intraindividually and with the MDB results. ResultsThe parameters area and amplitude correlated highly significantly with the MDB (P<0.001 for both tests). Decreasing the amplitude to at least 65% of its initial value indicated the presence of btx-ab. In that way 22 of 23 EDB classifications were identical to those of the MDB, yielding a sensitivity of 92.86% and a specificity of 100%. ConclusionThe EDB test is a reliable technique for detecting btx-ab with high sensitivity and specificity. The EDB test can replace the MDB.Der Nervenarzt 04/2012; 79(8):908-911. · 0.68 Impact Factor -
Article: [Proof of botulinum toxin antibodies with the Extensor Digitorum Brevis Test].
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ABSTRACT: Some patients treated with botulinum toxin (btx) develop neutralizing btx antibodies (btx-ab). The expensive Mouse Diaphragm Bioassay (MDB) is considered as the gold standard by many authors. We wanted to examine whether the Extensor Digitorum Brevis Test (EDB test) is a reliable method to test for btx-ab. We performed an electroneurography of the m. extensor digitorum brevis on both feet of 23 patients with known MDB. Afterwards the right feet were injected with 25 U of btx, and 21-28 days later the electroneurography was performed on both sides again. Finally we correlated the measured values (muscular wave latency, amplitude, area, and duration) intraindividually and with the MDB results. The parameters area and amplitude correlated highly significantly with the MDB (P<0.001 for both tests). Decreasing the amplitude to at least 65% of its initial value indicated the presence of btx-ab. In that way 22 of 23 EDB classifications were identical to those of the MDB, yielding a sensitivity of 92.86% and a specificity of 100%. The EDB test is a reliable technique for detecting btx-ab with high sensitivity and specificity. The EDB test can replace the MDB.Der Nervenarzt 05/2008; 79(8):908-11. · 0.68 Impact Factor
