Botulinum Neurotoxin for the Treatment of Motor and Vocal Tics

Over the past twenty years, Botulinum neurotoxin (BoNT) has emerged as a potential new treatment for motor and vocal tics. This review examines the safety profile and efficacy of BoNT for these indications. A Medline literature search using the keywords botulinum toxin, Tourette's syndrome, and tics was performed to identify relevant articles. Thirteen case reports, open-label studies, and randomized controlled trials were isolated and collected for review. Preliminary evidence from these studies suggests that BoNT can be a safe and effective treatment for tics. Though the mechanism through which BoNT suppresses tics is not clearly understood, it is notable that treatment with BoNT has been consistently reported to mitigate premonitory urges. Side effects are generally dependent upon on the injection site but are consistent with what has been observed with BoNT treatment for other hyperkinetic movement disorders. Much of the literature, however, consists of case reports and uncontrolled openlabel studies. Though initial results are promising, future studies are needed to better assess BoNT as a treatment for tics.