The Role of Ultrasound for the Personalized Botulinum Toxin Treatment of Cervical Dystonia

Fietzek, Urban M.; Nene, Devavrat; Schramm, Axel; Appel‐Cresswell, Silke; Košutzká, Zuzana; Walter, Uwe; Wissel, Jörg; Berweck, Steffen; Chouinard, Sylvain; Bäumer, Tobias

doi:10.3390/toxins13050365

Cited by 12 publications

(6 citation statements)

References 42 publications

(40 reference statements)

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“…Sonography is important for identifying target muscles and preventing damage to other tissues and is often used for cervical dystonia [170,171]. This method is also very useful for OMD and is recommended for use in combination with other methods such as EMG.…”

Section: Omdmentioning

confidence: 99%

Botulinum Toxin Therapy for Oromandibular Dystonia and Other Movement Disorders in the Stomatognathic System

Yoshida

2022

Toxins

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Various movement disorders, such as oromandibular dystonia, oral dyskinesia, bruxism, functional (psychogenic) movement disorder, and tremors, exist in the stomatognathic system. Most patients experiencing involuntary movements due to these disorders visit dentists or oral surgeons, who may be the first healthcare providers. However, differential diagnoses require neurological and dental knowledge. This study aimed to review scientific advances in botulinum toxin therapy for these conditions. The results indicated that botulinum toxin injection is effective and safe, with few side effects in most cases when properly administered by an experienced clinician. The diagnosis and treatment of movement disorders in the stomatognathic system require both neurological and dental or oral surgical knowledge and skills, and well-designed multicenter trials with a multidisciplinary team approach must be necessary to ensure accurate diagnosis and proper treatment.

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Section: Omdmentioning

confidence: 99%

Botulinum Toxin Therapy for Oromandibular Dystonia and Other Movement Disorders in the Stomatognathic System

Yoshida

2022

Toxins

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“…The OCI can be visualized at the C1 level, deep in the splenius capitis and semispinalis capitis. An out-of-plane injection approach is typically used [ 7 , 15 , 16 ]. Our center most commonly injects bilateral OCI using a starting dose of 10–15 U onabotulinum toxin A per side.…”

Section: Discussionmentioning

confidence: 99%

Botulinum Toxin Injections to the Obliquus Capitis Inferioris Muscle for Dynamic Cervical Dystonia Improves Subjective Patient Outcomes

Bessemer,

Jog

2024

Toxins

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The obliquus capitis inferioris (OCI) muscle is a significant driver of cervical dystonia with torticaput movements and a no–no head tremor. Limited data are available on the efficacy of OCI injections on patient outcomes. Our study aims to determine whether the botulinum toxin injection into OCI improves subjective patient quality of life in those with dystonic head tremors. A retrospective chart review was performed for 25 patients receiving injections into the OCI for a dystonic head tremor at the London Movement Disorders Clinic between January 2020 and January 2022. Toronto Western Spasmodic Torticollis Scale-2 (TWSTRS-2) subscale scores for disability and pain, TWSTRS-PSYCH scores, and the global impression of severity were extracted. The average TWSTRS-2 disability subscale change was −2.8 points (p < 0.003). The average TWSTRS-2 pain subscale change was −4.6 points (p < 0.003). The average TWSTRS-PSYCH score prior to injection was 5.6. After injection, the average score was 3.7 (p < 0.004). The patient self-reported average global impression of severity before injection was 7.0; after this, it was 4.2 (p < 0.0003). The OCI injection showed significant improvement in retrospective patient self-reported outcomes; it should be considered early in the treatment plan for cervical dystonia with a no–no head tremor.

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“…In our patient dystonic activity of the spinalis cervicis muscle was confirmed by electromyography (EMG). Ultrasound guided injection of 20 units incobotulinumtoxin significantly improved dystonic posturing [3]. This demonstrates the possible involvement of the spinalis cervices muscle in the dystonic pattern of CD, which is not part of standard injection schemes and might hence easily be overlooked.…”

mentioning

confidence: 87%

Hypertrophy of the Spinalis Cervicis Muscle in Cervical Dystonia

Loens,

Boppel,

Bäumer

2023

Tremor and Other Hyperkinetic Movements

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Background: Botulinum neurotoxin A (BoNT) is the first line treatment for cervical dystonia (CD) and treatment outcome significantly depends on the correct identification of the muscles involved.Phenomenology shown: In a case with insufficient response to BoNT treatment further work up with magnetic resonance imaging (MRI) of the neck revealed a hypertrophic spinalis cervicis muscle, that is not commonly involved in CD.Educational value: This highlights the use of MRI for muscle selection in treatment refractory CD cases.

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The Role of Ultrasound for the Personalized Botulinum Toxin Treatment of Cervical Dystonia

Cited by 12 publications

References 42 publications

Botulinum Toxin Therapy for Oromandibular Dystonia and Other Movement Disorders in the Stomatognathic System

Botulinum Toxin Therapy for Oromandibular Dystonia and Other Movement Disorders in the Stomatognathic System

Botulinum Toxin Injections to the Obliquus Capitis Inferioris Muscle for Dynamic Cervical Dystonia Improves Subjective Patient Outcomes

Hypertrophy of the Spinalis Cervicis Muscle in Cervical Dystonia

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