Clinical practice: evidence-based recommendations for the treatment of cervical dystonia with botulinum toxin

Contarino, Maria Fiorella and Van Den Dool, Joost and Balash, Yacov and Bhatia, Kailash and Giladi, Nir and Koelman, Johannes H. and Lokkegaard, Annemette and Marti, Maria J. and Postma, Miranda and Relja, Maja and Skorvanek, Matej and Speelman, Johannes D. and Zoons, Evelien and Ferreira, Joaquim J. and Vidailhet, Marie and Albanese, Alberto and Tijssen, Marina A. J. (2017) Clinical practice: evidence-based recommendations for the treatment of cervical dystonia with botulinum toxin. Frontiers in Neurology, 8. p. 35. ISSN 1664-2295

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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.

Item Type: Article
Additional Information: Copyright © 2017 Contarino, Van Den Dool, Balash, Bhatia, Giladi, Koelman, Lokkegaard, Marti, Postma, Relja, Skorvanek, Speelman, Zoons, Ferreira, Vidailhet, Albanese and Tijssen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Departments: Katedra za neurologiju
Depositing User: Martina Žužak
Status: Published
Contarino, Maria FiorellaUNSPECIFIED
Van Den Dool, JoostUNSPECIFIED
Bhatia, KailashUNSPECIFIED
Koelman, Johannes H.UNSPECIFIED
Lokkegaard, AnnemetteUNSPECIFIED
Postma, MirandaUNSPECIFIED
Skorvanek, MatejUNSPECIFIED
Speelman, Johannes D.UNSPECIFIED
Ferreira, Joaquim J.UNSPECIFIED
Vidailhet, MarieUNSPECIFIED
Albanese, AlbertoUNSPECIFIED
Tijssen, Marina A. J.UNSPECIFIED
Date: 24 February 2017
Date Deposited: 26 Jan 2018 10:26
Last Modified: 17 Aug 2020 09:19
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