Toxin for Tics: Practical Guidance for Clinicians from a Registry-Based Naturalistic Study.

[BACKGROUND] Botulinum toxin is a recommended treatment for tics. There is little practical guidance on the use of this treatment.

[OBJECTIVES] Our aim is to describe our experience using botulinum toxin injections for tics in adults. We provide information on tics treated, muscles injected, and dosages used to give practical guidance.

[METHODS] We analyzed data from the Calgary Adult Tic Registry on tic severity, the tics and muscles injected, and dosages. We assessed treatment length, reasons for discontinuation, and concurrent medications.

[RESULTS] Botulinum toxin was the most used medication for tics, received by 32 of 95 (33.7%) registry participants. Participants receiving botulinum toxin were significantly older and had significantly lower vocal tic severity and total tic severity. The most common motor tics treated were blinking, head turns, and shoulder raising. The mean length of treatment was 40.4 months.

[CONCLUSIONS] Botulinum toxin is an effective and well-tolerated treatment for adults with tics.