Botulinum toxin A--injection for cervical dystonia

Abstract

Spasmodic torticollis or cervical dystonia is the commonest focal dystonia. Botulinum toxin-A (BTX-A) was first used in its treatment in 1985. We are reporting our experience of treating 17 patients of cervical dystonia with 29 treatment sessions of BTX-A. The patients consisted of 13 men and four women with a mean age of 44.17 +/- 16.25 years who had tried medical therapy earlier. All patients had a combination of two or more abnormal postures of neck. Both Botox and Dysport were used as per availability. The mean dose of BTX-A in splenius capitus was 283.3 +/- 59.86 U of Dysport and 61.3 +/- 5.16 U of Botox and in sternocleidomastoid it was 210 +/- 53.47 U of Dysport and 46 +/- 18.97 U for Botox. After BTX-A injection, the response was observed after a mean of 9.7 +/- 5.7 days and the mean duration of effect was 15.56 +/- 7.13 weeks. Significant improvement of dystonia (global rating > or = 2) was seen after 25 of 29 treatment sessions (86%) and of pain was seen after four of five patients. Only three treatment sessions were followed by complications (10.4%) of these two had mild dysphagia and one had mild "flu-like" syndrome. We conclude BTX-A is safe and effective treatment of cervical dystonia.