Botulinum Toxin Injections to the Obliquus Capitis Inferioris Muscle for Dynamic Cervical Dystonia Improves...

Area of Science:

• Neurology
• Movement Disorders
• Neurosurgery

Background:

• The obliquus capitis inferioris (OCI) muscle is implicated in cervical dystonia, causing torticaput movements and no-no head tremors.
• Limited data exist on the effectiveness of OCI injections for patient outcomes in cervical dystonia.

Purpose of the Study:

• To evaluate the impact of botulinum toxin injections into the OCI muscle on the subjective quality of life in patients experiencing dystonic head tremors.

Main Methods:

• Retrospective chart review of 25 patients with dystonic head tremors who received OCI injections.
• Data collected included Toronto Western Spasmodic Torticollis Scale-2 (TWSTRS-2) disability and pain subscales, TWSTRS-PSYCH scores, and global impression of severity.

Main Results:

• Significant improvements were observed in TWSTRS-2 disability (average change -2.8, p < 0.003) and pain (average change -4.6, p < 0.003) subscales.
• TWSTRS-PSYCH scores decreased from 5.6 to 3.7 (p < 0.004), and global impression of severity improved from 7.0 to 4.2 (p < 0.0003).

Conclusions:

• OCI botulinum toxin injections demonstrate significant improvements in patient-reported outcomes for cervical dystonia with head tremors.
• Consideration of OCI injections early in the treatment plan for cervical dystonia with no-no head tremors is recommended.