Local Botulinum Toxin Type A Injection for the Management of Congenital Muscular Torticollis

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of local intramuscular botulinum toxin type A injection in patients with congenital muscular torticollis. METHOD: Six patients (mean age, 13.3 months) with congenital muscular torticollis who did not respond to physical therapy were participated with the informed consent of their parents. Twenty-five to fifty Speywood units of Dysport (Beaufour Ipsen, France) were injected into the palpated mass of the sternocleidomastoid muscle. The angle of tilt and range of motion of the neck in sitting position were obtained before and after injection. The size of the mass within the sternocleidomastoid muscle was measured with ultrasonogram. RESULTS: Satisfactory improvement of 3 parameters at post- injection 6-month follow-up was achieved in all patients. The tilting angle and range of motion of the neck to rotation were normalized in 5 patients. The size of the mass within the sternocleidomastoid muscle was decreased significantly with ultrasonographic evaluation. CONCLUSION: Local intramuscular BTA injection might be effective for patients with congenital muscular torticollis who do not respond to conservative management.