TY - JOUR

T1 - Clinical Practice

T2 - Evidence-Based Recommendations for the Treatment of Cervical Dystonia with Botulinum Toxin

AU - Contarino, Maria Fiorella

AU - Van Den Dool, Joost

AU - Balash, Yacov

AU - Bhatia, Kailash

AU - Giladi, Nir

AU - Koelman, Johannes H

AU - Lokkegaard, Annemette

AU - Marti, Maria J

AU - Postma, Miranda

AU - Relja, Maja

AU - Skorvanek, Matej

AU - Speelman, Johannes D

AU - Zoons, Evelien

AU - Ferreira, Joaquim J

AU - Vidailhet, Marie

AU - Albanese, Alberto

AU - Tijssen, Marina A J

PY - 2017

Y1 - 2017

N2 - Cervical dystonia (CD) is the most frequent form of focal dystonia. Symptoms often result in pain and functional disability. Local injections of botulinum neurotoxin are currently the treatment of choice for CD. Although this treatment has proven effective and is widely applied worldwide, many issues still remain open in the clinical practice. We performed a systematic review of the literature on botulinum toxin treatment for CD based on a question-oriented approach, with the aim to provide practical recommendations for the treating clinicians. Key questions from the clinical practice were explored. Results suggest that while the beneficial effect of botulinum toxin treatment on different aspects of CD is well established, robust evidence is still missing concerning some practical aspects, such as dose equivalence between different formulations, optimal treatment intervals, treatment approaches, and the use of supportive techniques including electromyography or ultrasounds. Established strategies to prevent or manage common side effects (including excessive muscle weakness, pain at injection site, dysphagia) and potential contraindications to this treatment (pregnancy and lactation, use of anticoagulants, neurological comorbidities) should also be further explored.

AB - Cervical dystonia (CD) is the most frequent form of focal dystonia. Symptoms often result in pain and functional disability. Local injections of botulinum neurotoxin are currently the treatment of choice for CD. Although this treatment has proven effective and is widely applied worldwide, many issues still remain open in the clinical practice. We performed a systematic review of the literature on botulinum toxin treatment for CD based on a question-oriented approach, with the aim to provide practical recommendations for the treating clinicians. Key questions from the clinical practice were explored. Results suggest that while the beneficial effect of botulinum toxin treatment on different aspects of CD is well established, robust evidence is still missing concerning some practical aspects, such as dose equivalence between different formulations, optimal treatment intervals, treatment approaches, and the use of supportive techniques including electromyography or ultrasounds. Established strategies to prevent or manage common side effects (including excessive muscle weakness, pain at injection site, dysphagia) and potential contraindications to this treatment (pregnancy and lactation, use of anticoagulants, neurological comorbidities) should also be further explored.

KW - Journal Article

KW - Review

U2 - 10.3389/fneur.2017.00035

DO - 10.3389/fneur.2017.00035

M3 - Review

C2 - 28286494

VL - 8

JO - Frontiers in Neurology

JF - Frontiers in Neurology

SN - 1664-2295

M1 - 35

ER -