

	This program is jointly sponsored by The Institute for Medical Studies and the Neurotoxin Institute. Supported by an unrestricted educational grant from Allergan, Inc. Accreditation Statement This CME activity was planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Institute for Medical Studies (IMS) and the Neurotoxin Institute (NTI). The IMS is accredited by the ACCME to provide continuing medical education for physicians. The IMS designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with their participation in the activity. This CME DVD is designed to meet the needs of physicians who manage patients with movement disorders and/or headache. The date of the original release of this program was May 2003. The date of the most recent review was July 2007. CME accreditation for this program will remain in effect through December 2009. Faculty: Joseph Jankovic, MD, Chairman Professor of Neurology Director, Parkinson’s Disease Center and Movement Disorders Clinic Department of Neurology Baylor College of Medicine Houston, Texas Stephen D. Silberstein, MD, FACP Director, Jefferson Headache Center Thomas Jefferson University Hospital Professor of Neurology Jefferson Medical College Philadelphia, Pennsylvania Andrew M. Blumenfeld, MD Director The Headache Center of Southern California Del Mar, California CME Advisor: Stanley A. Golanty, MD Medical Director The Institute for Medical Studies Laguna Niguel, California Faculty Disclosures It is the policy of The Institute for Medical Studies (IMS) to ensure balance, independence, objectivity, and scientific rigor in all its individually sponsored or jointly sponsored educational activities. Therefore, in accordance with ACCME guidelines, the IMS requires that the faculty members for CME activities disclose any relationships that are germane to the subject matter of the continuing education activity. This requirement pertains to relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the presentation topic. Having an interest in or affiliation with any corporate organization does not prevent a speaker from making a presentation, but the relationship must be made known to the audience in advance to be in compliance with ACCME guidelines. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias in either the exposition or the conclusions presented. Joseph Jankovic, MD, serves as a consultant for Merz Pharma and Allergan, Inc. He has received grants/research support from Allergan, Inc., Ipsen, and Merz Pharma. Stephen D. Silberstein, MD, FACP, is on the advisory panel and received grants, research support, and honoraria from Allergan, Inc., and Medtronic. Andrew M. Blumenfeld, MD, serves as a consultant and a member of an advisory board for Allergan Neurosciences. He has received grants and research support from Allergan Neurosciences and is a holder of patents from Allergan Neurosciences. Botulinum neurotoxins are not FDA approved for use in headache. Please refer to the package insert for approved uses. Target Audience This DVD is designed for physicians who manage patients with movement disorders and/or headache. Learning Objectives After viewing the DVD, participants should be able to: Discuss the efficacy of botulinum neurotoxins (BoNTs) in the treatment of cervical dystonia, blepharospasm, and headache Describe treatment options for patients with cervical dystonia, blepharospasm, and headache Review condition-specific dosing, injection-site selection, and injection technique Discuss patient management, including postinjection care and patient compliance Statement of Need A needs assessment was conducted by reviewing the literature and discussing the management and treatment of movement disorders and/or headache with several neurologists (Joseph Jankovic, MD; Alberto Albanese, MD; Stephen D. Silberstein, MD, FACP; B. Todd Troost, MD; and Andrew M. Blumenfeld, MD). Movement disorders include a spectrum of conditions, including cervical dystonia and blepharospasm, associated with differing levels of pain and disability. BoNTs have been used in patients with these disorders for many years, achieving dramatic and sustained improvements in patient function. Headache disorders affect roughly 45 million Americans. The significant impact of pain and disability from migraine and other headache disorders on social function, quality of life, and general health imposes a large burden on the utilization of healthcare services, society, and the affected individuals. Despite the development of a variety of pharmacologic approaches to the management of episodic and chronic headache disorders, individuals affected remain undertreated, in part because of limited use of preventive therapies and associated safety and tolerability issues. BoNT is a promising new approach to preventive headache therapy that potentially addresses many of the currently unmet needs in this therapeutic area. Although BoNT is not yet approved for use in headache, the unmet clinical need in this area has led to its introduction in many headache clinics. There are broad variations in the use of BoNT in headache. Movement Disorders and Beyond will provide physicians with an improved understanding of the role and application of BoNTs in the management of cervical dystonia, blepharospasm, and headache. The DVD will demonstrate various injection techniques for BoNT. It will also provide guidance on how to prepare patients for treatment and ensure the best treatment results.