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Head and neck muscle spasm after radiotherapy: management with botulinum toxin A injection
Douglas J Van Daele1, Eileen M Finnegan, Robert L Rodnitzky
1Department of Otolaryngology-Head and Neck Surgery, University of Iowa Health Care, Iowa City 52242, USA. douglas-van-daele@uiowa.edu
Objective:
To introduce the concept of neck muscle pain and spasm after radiotherapy and its treatment with botulinum toxin A.
Design:
Case series.
Setting:
Ambulatory patients at a tertiary care medical center.
Patients:
Individuals who had undergone primary or adjuvant radiotherapy for treatment of carcinoma of the head and neck were asked about painful spasms of the neck musculature. A volunteer sample was used. If they desired treatment with botulinum toxin A, they were included in the study.
Intervention:
Patients received botulinum toxin A injections to the affected sternocleidomastoid muscle(s) in 1 or 2 locations.
Outcome Measure:
Subjective pain relief.
Results:
Four of 6 patients with painful tightness of the neck who received botulinum toxin A injections to the sternocleidomastoid muscle achieved pain relief.
Conclusions:
A subset of patients with irradiation-induced cervical muscle spasm benefit from treatment with botulinum toxin A injections. Further study is needed to more clearly define the entity and treatment.