Cervical dystonia (CD) is the most common focal dystonia that is characterized by involuntary contraction of cervical muscles causing abnormal head movements and postures. The treatment for CD was previously limited to oral medications, however, with consequent systemic side effects. In recent years, botulinum toxin (BoNT) has demonstrated efficacy in several studies and thus has received level A recommendation from both the American Academy of Neurology and the European Federation of Neurological Sciences in the treatment of dystonia. In many countries, it is the first‐line treatment for CD. There are four types of toxin approved for the use in CD, three type A [OnabotulinumtoxinA (OnaBoNTA), AbobotulinumtoxinA (AboBoNTA), and Incobotulinumtoxin A (IncoBoNTA)] and one type B [RimabotulinumtoxinB (RimaBoNTB)]. Proper selection of affected muscles and dose of toxin are important parameters in successfully providing symptomatic treatment. Good response rate is defined as improvement of more than 25 % from baseline using the Toronto Western Torticollis Rating Scale. The most common side effect of chemodenervation with BoNT for CD is dysphagia.
Part of the book: Botulinum Toxin Therapy Manual for Dystonia and Spasticity