Clinical value and advances of electromyography in cervical dystonia: a review

Electromyography (EMG) is a definitive diagnostic tool that has become indispensable in the clinical management of cervical dystonia (CD). This review systematically delineates its pivotal role across the entire care pathway. EMG provides crucial electrophysiological evidence for the diagnosis and differential diagnosis of CD by identifying abnormal co-contractions and "recruitment" phenomena. In therapeutic management, EMG-guided botulinum toxin injections enable precise targeting of affected muscles, significantly improving therapeutic efficacy and reducing adverse reactions. It also offers objective references for target muscle selection and parameter optimization in interventions such as deep brain stimulation. Research on pathophysiological mechanisms reveals that EMG captures abnormalities in central pattern generators, offering insights into the underlying neurophysiological mechanisms of CD. Moreover, EMG serves as a reliable tool for quantifying therapeutic effects and conducting long-term follow-ups. Despite limitations such as operator dependence, emerging technologies-including high-density surface EMG and machine learning-are expanding the role of EMG in precision medicine and individualized treatment strategies for CD. This review highlights the clinical value, advances, and future prospects of EMG in the diagnosis, classification, pathophysiological research, treatment guidance, and efficacy evaluation of CD.