Injection Sites and Doses in the Treatment of Cervical Dystonia with Botulinum A Toxin: A Preliminary Report

ABSTRACT

We administered local injections of botulinum A toxin to 15 patients wlth medically intratrable cervical dystonia Thirteen of the patients (87%) improved substantially (global effect >or=3 ; fiom -l = aggravated to +5 = markedly improved, fully functional, very happy with the results), with a mean total dose of 75.9 units. Of the 8 patients who reported pain, 7 (88%) had almost complete re!ief of pain. Only 6 of 15 (40%) patients had mild to moderate complications. More muscles had been injected in rotatocollis (mean, 5.2) than in laterocollis (mean, 3.0) (p<0.05). The global effects in rotatocollis (mean, 3.4) and laterocollis (mean, 3.3) were significantly better than anterocollis (mean, 1.5) (p<0.05). We conclude that botulinum A toxin is also effective in low doses when given in due consideration of the cervical muscle contraction patterns.