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Botulinum a toxin for spasmodic torticollis: multiple vs single injection points per muscle
G E Borodic1, L B Pearce, K Smith
1Massachusetts Eye and Ear Infirmary, Harvard Medical School, Cambridge.
Head & Neck
|January 1, 1992
Summary
Multiple injections per muscle for spasmodic torticollis offer superior pain relief and improved function compared to single injections. This study highlights an effective injection technique for managing adult onset spasmodic torticollis symptoms.
Area of Science:
- Neurology
- Physical Medicine
- Rehabilitation
Background:
- Spasmodic torticollis, a form of cervical dystonia, causes involuntary neck muscle contractions.
- Current treatments include botulinum toxin injections, but optimal injection techniques require further investigation.
Purpose of the Study:
- To compare the efficacy of single-point versus multiple-point injection techniques in treating adult onset spasmodic torticollis.
- To assess the impact of injection strategy on key clinical parameters of the condition.
Main Methods:
- Retrospective analysis of 86 injections in 49 patients with adult onset spasmodic torticollis.
- Evaluation of pain, posture deformity, cervical range of motion, disfigurement, muscle hypertrophy, activity limitation, and involuntary movement.
- Comparison of outcomes between single-point and multiple-point per muscle injection strategies.
Main Results:
- Multiple-point injections demonstrated statistically significant superiority in reducing pain (p<0.002), improving posture (p<0.001), increasing range of motion (p<0.001), and enhancing activity endurance (p<0.001).
- No significant differences were observed in cervical muscle hypertrophy or degree of involuntary movements between the two techniques.
- Both injection methods were considered beneficial for all assessed components of spasmodic torticollis.
Conclusions:
- The multiple-point per muscle injection technique is a more effective strategy for managing adult onset spasmodic torticollis than the single-point technique.
- This refined injection approach offers improved outcomes for pain, posture, mobility, and functional capacity in patients with spasmodic torticollis.