Skip to main content
SpringerLink
Log in

The treatment of cervical dystonia with botulinum toxins

  • Published:
Journal of Neural Transmission Aims and scope Submit manuscript

Summary

Botulinum neurotoxin (BoNT) treatment has been used extensively for the treatment of cervical dystonia. There are three established brands and two serotypes of BoNT commercially available in most of the world, and several additional brands are available in selected geographic regions. In most controlled studies, there is significant improvement following treatment for head posture, pain and disability. The common side effects of treatment include dysphagia, dry mouth, and neck weakness. Each brand and serotype is pharmacologically distinct. The dosing of each type differs, and no simple dose equivalency has been established. With repeated treatment, the development of immunoresistance is observed in a percentage of patients. However, it is likely that each brand and serotype may differ in immunogenic potential and occurrence of secondary unresponsiveness, an issue that is currently under active investigation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • R Benecke WH Jost P Kanovsky E Ruzicka G Comes S Grafe (2005) ArticleTitleA new botulinum toxin type A free of complexing proteins for treatment of cervical dystonia Neurology 64 1949–1951 Occurrence Handle15955951 Occurrence Handle10.1212/01.WNL.0000163767.99354.C3 Occurrence Handle1:CAS:528:DC%2BD2MXksVaisLc%3D

    Article  PubMed  CAS  Google Scholar 

  • B Berman L Seeberger R Kumar (2004) ArticleTitleLong-term safety, efficacy, dosing, and development of resistance with botulinum toxin type B in cervical dystonia Mov Disord 20 233–237 Occurrence Handle10.1002/mds.20290

    Article  Google Scholar 

  • JW Brans R Lindeboom JW Snoek MJ Zwarts TW van Weerden ER Brunt JJ van Hilten W van der Kamp MH Prins JD Speelman (1996) ArticleTitleBotulinum toxin versus trihexyphenidyl in cervical dystonia: a prospective, randomized, double-blind controlled trial Neurology 46 1066–1072 Occurrence Handle8780093 Occurrence Handle1:STN:280:DyaK28zntlyjsA%3D%3D

    PubMed  CAS  Google Scholar 

  • A Brashear MF Lew DD Dykstra CL Comella SA Factor RL Rodnitzky R Trosch C Singer MF Brin JJ Murray JD Wallace A Willmer-Hulme M Koller (1999) ArticleTitleSafety and efficacy of NeuroBloc (botulinum toxin type B) in type A-responsive cervical dystonia Neurology 53 1439–1446 Occurrence Handle10534248 Occurrence Handle1:CAS:528:DyaK1MXntlWhu7g%3D

    PubMed  CAS  Google Scholar 

  • A Brashear K Bergan J Wojcieszek ER Siemers W Ambrosius (2000) ArticleTitlePatient’s perception of stopping or continuing treatment of cervical dystonia with botulinum toxin type A Mov Disord 15 150–153 Occurrence Handle10634256 Occurrence Handle10.1002/1531-8257(200001)15:1<150::AID-MDS1024>3.0.CO;2-X Occurrence Handle1:STN:280:DC%2BD3c%2FpslOhsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • MF Brin MF Lew CH Adler CL Comella SA Factor J Jankovic C O’Brien JJ Murray JD Wallace A Willmer-Hulme M Koller (1999) ArticleTitleSafety and efficacy of NeuroBloc (botulinum toxin type B) in type A-resistant cervical dystonia Neurology 53 1431–1438 Occurrence Handle10534247 Occurrence Handle1:CAS:528:DyaK1MXntlWhu7s%3D

    PubMed  CAS  Google Scholar 

  • L Camfield Y Ben-Shlomo TT Warner (2002) ArticleTitleImpact of cervical dystonia on quality of life Mov Disord 17 838–841 Occurrence Handle12210891 Occurrence Handle10.1002/mds.10127

    Article  PubMed  Google Scholar 

  • J Chan MF Brin S Fahn (1991) ArticleTitleIdiopathic cervical dystonia: clinical characteristics Mov Disord 6 119–126 Occurrence Handle2057004 Occurrence Handle10.1002/mds.870060206 Occurrence Handle1:STN:280:DyaK3M3nvVyqsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • CL Comella J Jankovic KM Shannon J Tsui M Swenson S Leurgans W Fan (2005) ArticleTitleComparison of botulinum toxin serotypes A and B for the treatment of cervical dystonia Neurology 65 1423–1429 Occurrence Handle16275831 Occurrence Handle10.1212/01.wnl.0000183055.81056.5c Occurrence Handle1:STN:280:DC%2BD2Mrps12ltg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • SR Filipovic M Jahanshahi R Viswanathan P Heywood D Rogers KP Bhatia (2004) ArticleTitleClinical features of the geste antagoniste in cervical dystonia Adv Neurol 94 191–201 Occurrence Handle14509673

    PubMed  Google Scholar 

  • DJ Gelb DH Lowenstein MJ Aminoff (1989) ArticleTitleControlled trial of botulinum toxin injections in the treatment of spasmodic torticollis Neurology 39 80–84 Occurrence Handle2642616 Occurrence Handle1:STN:280:DyaL1M%2Fot1ymuw%3D%3D

    PubMed  CAS  Google Scholar 

  • N Giladi J Meer H Kidan S Honigman (2000) ArticleTitleLong-term remission of idiopathic cervical dystonia after treatment with botulinum toxin Eur Neurol 44 144–146 Occurrence Handle11053961 Occurrence Handle10.1159/000008223 Occurrence Handle1:CAS:528:DC%2BD3cXotVCquro%3D

    Article  PubMed  CAS  Google Scholar 

  • P Greene U Kang S Fahn M Brin C Moskowitz E Flaster (1990) ArticleTitleDouble-blind, placebo-controlled trial of botulinum toxin injections for the treatment of spasmodic torticollis Neurology 40 1213–1218 Occurrence Handle2199847 Occurrence Handle1:STN:280:DyaK3czktVCrug%3D%3D

    PubMed  CAS  Google Scholar 

  • JM Hagenah A Vieregge P Vieregge (2001) ArticleTitleRadiculopathy and myelopathy in patients with primary cervical dystonia Eur Neurol 45 236–240 Occurrence Handle11385261 Occurrence Handle10.1159/000052135 Occurrence Handle1:STN:280:DC%2BD3MzhtFyjtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • J Jankovic S Leder D Warner K Schwartz (1991) ArticleTitleCervical dystonia: clinical findings and associated movement disorders Neurology 41 1088–1091 Occurrence Handle2067638 Occurrence Handle1:STN:280:DyaK3M3ps1WhsA%3D%3D

    PubMed  CAS  Google Scholar 

  • J Jankovic KD Vuong J Ahsan (2003) ArticleTitleComparison of efficacy and immunogenicity of original versus current botulinum toxin in cervical dystonia Neurology 60 1186–1188 Occurrence Handle12682332 Occurrence Handle1:STN:280:DC%2BD3s7msFSgtw%3D%3D

    PubMed  CAS  Google Scholar 

  • KR Kessler M Skutta R Benecke (1999) ArticleTitleLong-term treatment of cervical dystonia with botulinum toxin A: efficacy, safety, and antibody frequency. German Dystonia Study Group J Neurol 246 265–274 Occurrence Handle10367694 Occurrence Handle10.1007/s004150050345 Occurrence Handle1:STN:280:DyaK1M3psVWitg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • MF Lew BT Adornato DD Duane DD Dykstra SA Factor JM Massey MF Brin J Jankovic RL Rodnitzky C Singer MR Swenson D Tarsy JJ Murray M Koller JD Wallace (1997) ArticleTitleBotulinum toxin type B: a double-blind, placebo-controlled, safety and efficacy study in cervical dystonia Neurology 49 701–707 Occurrence Handle9305326 Occurrence Handle1:CAS:528:DyaK2sXmtlOmsbk%3D

    PubMed  CAS  Google Scholar 

  • IT Lorentz SS Subramaniam C Yiannikas (1991) ArticleTitleTreatment of idiopathic spasmodic torticollis with botulinum toxin A: a double-blind study on twenty-three patients Mov Disord 6 145–150 Occurrence Handle2057005 Occurrence Handle10.1002/mds.870060210 Occurrence Handle1:STN:280:DyaK3M3nvVyqtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • A Marchetti R Magar L Findley JP Larsen Z Pirtosek E Ruzicka R Jech J Slawek F Ahmed (2005) ArticleTitleRetrospective evaluation of the dose of Dysport and BOTOX in the management of cervical dystonia and blepharospasm: the REAL DOSE study Mov Disord 20 937–944 Occurrence Handle15810022 Occurrence Handle10.1002/mds.20468

    Article  PubMed  Google Scholar 

  • T Odergren H Hjaltason S Kaakkola G Solders J Hanko C Fehling RJ Marttila H Lundh S Gedin I Westergren A Richardson C Dott H Cohen (1998) ArticleTitleA double blind, randomised, parallel group study to investigate the dose equivalence of Dysport and Botox in the treatment of cervical dystonia J Neurol Neurosurg Psychiatry 64 6–12 Occurrence Handle9436720 Occurrence Handle1:STN:280:DyaK1c%2Fpslahsg%3D%3D

    PubMed  CAS  Google Scholar 

  • W Poewe L Schelosky B Kleedorfer F Heinen M Wagner G Deuschl (1992) ArticleTitleTreatment of spasmodic torticollis with local injections of botulinum toxin. One-year follow-up in 37 patients J Neurol 239 21–25 Occurrence Handle1541964 Occurrence Handle10.1007/BF00839206 Occurrence Handle1:STN:280:DyaK387ns12lsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • W Poewe G Deuschl A Nebe E Feifel J Wissel R Benecke KR Kessler AO Ceballos-Baumann A Ohly W Oertel G Kunig (1998) ArticleTitleWhat is the optimal dose of botulinum toxin A in the treatment of cervical dystonia? Results of a double blind, placebo controlled, dose ranging study using Dysport. German Dystonia Study Group J Neurol Neurosurg Psychiatry 64 13–17 Occurrence Handle9436721 Occurrence Handle1:STN:280:DyaK1c%2Fpslahsw%3D%3D Occurrence Handle10.1136/jnnp.64.1.13

    Article  PubMed  CAS  Google Scholar 

  • D Ranoux C Gury J Fondarai JL Mas M Zuber (2002) ArticleTitleRespective potencies of Botox and Dysport: a double blind, randomised, crossover study in cervical dystonia J Neurol Neurosurg Psychiatry 72 459–462 Occurrence Handle11909903 Occurrence Handle1:STN:280:DC%2BD387nslejsQ%3D%3D

    PubMed  CAS  Google Scholar 

  • C Sampaio J Costa JJ Ferreira (2004) ArticleTitleClinical comparability of marketed formulations of botulinum toxin Mov Disord 19 IssueIDSuppl 8 S129–S136 Occurrence Handle15027065 Occurrence Handle10.1002/mds.20066

    Article  PubMed  Google Scholar 

  • CM Shaari I Sanders (1993) ArticleTitleQuantifying how location and dose of botulinum toxin injections affect muscle paralysis Muscle Nerve 16 964–969 Occurrence Handle8355728 Occurrence Handle10.1002/mus.880160913 Occurrence Handle1:STN:280:DyaK3szmtFSmsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • CM Shaari BL Wu HF Biller SK Chuang I Sanders (1998) ArticleTitleBotulinum toxin decreases salivation from canine submandibular glands Otolaryngol Head Neck Surg 118 452–457 Occurrence Handle9560094 Occurrence Handle10.1016/S0194-5998(98)70200-1 Occurrence Handle1:STN:280:DyaK1c3hvFShsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • D Truong DD Duane J Jankovic C Singer LC Seeberger CL Comella MF Lew RL Rodnitzky FO Danisi JP Sutton PD Charles RA Hauser GL Sheean (2005) ArticleTitleEfficacy and safety of botulinum type A toxin (Dysport) in cervical dystonia: results of the first US randomized, double-blind, placebo-controlled study Mov Disord 20 783–791 Occurrence Handle15736159 Occurrence Handle10.1002/mds.20403

    Article  PubMed  Google Scholar 

  • JK Tsui A Eisen E Mak J Carruthers A Scott DB Calne (1985) ArticleTitleA pilot study on the use of botulinum toxin in spasmodic torticollis Can J Neurol Sci 12 314–316 Occurrence Handle4084867 Occurrence Handle1:STN:280:DyaL287gsFCksQ%3D%3D

    PubMed  CAS  Google Scholar 

  • JK Tsui A Eisen AJ Stoessl S Calne DB Calne (1986) ArticleTitleDouble-blind study of botulinum toxin in spasmodic torticollis Lancet 2 245–247 Occurrence Handle2874278 Occurrence Handle10.1016/S0140-6736(86)92070-2 Occurrence Handle1:STN:280:DyaL283otlOntQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA

    C. L. Comella

Authors
  1. C. L. Comella
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. L. Comella.

Additional information

Correspondence: Cynthia L. Comella, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA

Rights and permissions

Reprints and permissions

About this article

Cite this article

Comella, C. The treatment of cervical dystonia with botulinum toxins. J Neural Transm 115, 579–583 (2008). https://doi.org/10.1007/s00702-007-0831-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00702-007-0831-4

Search

Navigation