Strategy for starting BoNT treatment (written consent, initial dose and subsequent doses, interval, follow-up)

Botulinum toxin (BoNT) has become a therapeutic agent for a large variety of medical conditions. It is a symptomatic treatment and in most cases requires repeat injections at regular intervals. The first session is crucial in establishing rapport between the physician and the patient to ensure a continuity of treatment on a long term basis. Since the clinical practice varies widely across different therapeutic indications and in different clinical settings around the world, a general set of strategic approach is difficult to be formulated. This article will focus on the important issues when starting BoNT treatment in patients with cervical dystonia (CD).