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 -