The effectiveness of using a centrally acting muscle relaxant in combination with botulinum toxin injections in patients with spasmodic torticollis

Objective. To analyze the efficacy of eperison in combination with botulinum toxin injections for the treatment of pain syndrome in patients with spastic torticollis (ST). Material and methods. A retrospective study was conducted to evaluate the effectiveness of eperison administration alongside botulinum therapy in 29 patients diagnosed with ST. The study employed a cross-sectional retrospective analysis of medical data. Patients receiving botulinum toxin injections at three-month intervals (a total of 6 cycles), with assessments at 2 months (4—6 cycles after each injection), were administered eperison at a dose of 150 mg/day. The efficacy of the treatments was evaluated using a validated scale: the 85-point TWSTRS (Toronto Western Spasmodic Torticollis Rating Scale), assessed three times—before each botulinum injection (on day 1), at day 14, and and at day 60 later. Results. For cycles 1—3 (botulinum toxin, without eperisone), the average TWSTRS scale score on the on day 1 of each cycle was 40.72 — 41.66; cycles 4—6 with the addition of Eperisone — 26.6—30.4 points. When comparing the average values of the TWSTRS scale for cycles 1—3 and cycles 4—6 on the «Pain» scale, t-test value was: 15.85 (p=0.000546). Conclusion. The intake of the centrally acting muscle relaxant eperison resulted in a statistically significant improvement in patients with ST by the time of the next injection (paired Student’s t-test 2.77—2.92, p=0.05), including improvements in the «Pain» scale, compared to botulinum therapy without eperison in the same patients.