Clinical Practice: Evidence-Based Recommendations for the Treatment of Cervical Dystonia with Botulinum Toxin

Maria Fiorella Contarino; Joost Van Den Dool; Yacov Balash; Kailash Bhatia; Nir Giladi; Johannes H Koelman; Annemette Lokkegaard; Maria J Marti; Miranda Postma; Maja Relja; Matej Skorvanek; Johannes D Speelman; Evelien Zoons; Joaquim J Ferreira; Marie Vidailhet; Alberto Albanese; Marina A J Tijssen

doi:10.3389/fneur.2017.00035

Clinical Practice: Evidence-Based Recommendations for the Treatment of Cervical Dystonia with Botulinum Toxin

Maria Fiorella Contarino, Joost Van Den Dool, Yacov Balash, Kailash Bhatia, Nir Giladi, Johannes H Koelman, Annemette Lokkegaard, Maria J Marti, Miranda Postma, Maja Relja, Matej Skorvanek, Johannes D Speelman, Evelien Zoons, Joaquim J Ferreira, Marie Vidailhet, Alberto Albanese, Marina A J Tijssen

Department of Clinical Medicine

32 Citations (Scopus)

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Abstract

Cervical dystonia (CD) is the most frequent form of focal dystonia. Symptoms often result in pain and functional disability. Local injections of botulinum neurotoxin are currently the treatment of choice for CD. Although this treatment has proven effective and is widely applied worldwide, many issues still remain open in the clinical practice. We performed a systematic review of the literature on botulinum toxin treatment for CD based on a question-oriented approach, with the aim to provide practical recommendations for the treating clinicians. Key questions from the clinical practice were explored. Results suggest that while the beneficial effect of botulinum toxin treatment on different aspects of CD is well established, robust evidence is still missing concerning some practical aspects, such as dose equivalence between different formulations, optimal treatment intervals, treatment approaches, and the use of supportive techniques including electromyography or ultrasounds. Established strategies to prevent or manage common side effects (including excessive muscle weakness, pain at injection site, dysphagia) and potential contraindications to this treatment (pregnancy and lactation, use of anticoagulants, neurological comorbidities) should also be further explored.

Original language	English
Article number	35
Journal	Frontiers in Neurology
Volume	8
Number of pages	11
ISSN	1664-2295
DOIs	https://doi.org/10.3389/fneur.2017.00035
Publication status	Published - 24 Feb 2017

Keywords

Journal Article
Review

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10.3389/fneur.2017.00035Licence: CC BY

Clinical Practice: Evidence-Based Recommendations for the Treatment of Cervical Dystonia with Botulinum ToxinFinal published version, 276 KBLicence: CC BY

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Contarino, M. F., Van Den Dool, J., Balash, Y., Bhatia, K., Giladi, N., Koelman, J. H., Lokkegaard, A., Marti, M. J., Postma, M., Relja, M., Skorvanek, M., Speelman, J. D., Zoons, E., Ferreira, J. J., Vidailhet, M., Albanese, A., & Tijssen, M. A. J. (2017). Clinical Practice: Evidence-Based Recommendations for the Treatment of Cervical Dystonia with Botulinum Toxin. Frontiers in Neurology, 8, Article 35. https://doi.org/10.3389/fneur.2017.00035

Contarino, MF, Van Den Dool, J, Balash, Y, Bhatia, K, Giladi, N, Koelman, JH, Lokkegaard, A, Marti, MJ, Postma, M, Relja, M, Skorvanek, M, Speelman, JD, Zoons, E, Ferreira, JJ, Vidailhet, M, Albanese, A & Tijssen, MAJ 2017, 'Clinical Practice: Evidence-Based Recommendations for the Treatment of Cervical Dystonia with Botulinum Toxin', Frontiers in Neurology, vol. 8, 35. https://doi.org/10.3389/fneur.2017.00035

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abstract = "Cervical dystonia (CD) is the most frequent form of focal dystonia. Symptoms often result in pain and functional disability. Local injections of botulinum neurotoxin are currently the treatment of choice for CD. Although this treatment has proven effective and is widely applied worldwide, many issues still remain open in the clinical practice. We performed a systematic review of the literature on botulinum toxin treatment for CD based on a question-oriented approach, with the aim to provide practical recommendations for the treating clinicians. Key questions from the clinical practice were explored. Results suggest that while the beneficial effect of botulinum toxin treatment on different aspects of CD is well established, robust evidence is still missing concerning some practical aspects, such as dose equivalence between different formulations, optimal treatment intervals, treatment approaches, and the use of supportive techniques including electromyography or ultrasounds. Established strategies to prevent or manage common side effects (including excessive muscle weakness, pain at injection site, dysphagia) and potential contraindications to this treatment (pregnancy and lactation, use of anticoagulants, neurological comorbidities) should also be further explored.",

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T2 - Evidence-Based Recommendations for the Treatment of Cervical Dystonia with Botulinum Toxin

AU - Contarino, Maria Fiorella

AU - Van Den Dool, Joost

AU - Balash, Yacov

AU - Bhatia, Kailash

AU - Giladi, Nir

AU - Koelman, Johannes H

AU - Lokkegaard, Annemette

AU - Marti, Maria J

AU - Postma, Miranda

AU - Relja, Maja

AU - Skorvanek, Matej

AU - Speelman, Johannes D

AU - Zoons, Evelien

AU - Ferreira, Joaquim J

AU - Vidailhet, Marie

AU - Albanese, Alberto

AU - Tijssen, Marina A J

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N2 - Cervical dystonia (CD) is the most frequent form of focal dystonia. Symptoms often result in pain and functional disability. Local injections of botulinum neurotoxin are currently the treatment of choice for CD. Although this treatment has proven effective and is widely applied worldwide, many issues still remain open in the clinical practice. We performed a systematic review of the literature on botulinum toxin treatment for CD based on a question-oriented approach, with the aim to provide practical recommendations for the treating clinicians. Key questions from the clinical practice were explored. Results suggest that while the beneficial effect of botulinum toxin treatment on different aspects of CD is well established, robust evidence is still missing concerning some practical aspects, such as dose equivalence between different formulations, optimal treatment intervals, treatment approaches, and the use of supportive techniques including electromyography or ultrasounds. Established strategies to prevent or manage common side effects (including excessive muscle weakness, pain at injection site, dysphagia) and potential contraindications to this treatment (pregnancy and lactation, use of anticoagulants, neurological comorbidities) should also be further explored.

AB - Cervical dystonia (CD) is the most frequent form of focal dystonia. Symptoms often result in pain and functional disability. Local injections of botulinum neurotoxin are currently the treatment of choice for CD. Although this treatment has proven effective and is widely applied worldwide, many issues still remain open in the clinical practice. We performed a systematic review of the literature on botulinum toxin treatment for CD based on a question-oriented approach, with the aim to provide practical recommendations for the treating clinicians. Key questions from the clinical practice were explored. Results suggest that while the beneficial effect of botulinum toxin treatment on different aspects of CD is well established, robust evidence is still missing concerning some practical aspects, such as dose equivalence between different formulations, optimal treatment intervals, treatment approaches, and the use of supportive techniques including electromyography or ultrasounds. Established strategies to prevent or manage common side effects (including excessive muscle weakness, pain at injection site, dysphagia) and potential contraindications to this treatment (pregnancy and lactation, use of anticoagulants, neurological comorbidities) should also be further explored.

KW - Journal Article

KW - Review

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DO - 10.3389/fneur.2017.00035

M3 - Review

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SN - 1664-2295

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JO - Frontiers in Neurology

JF - Frontiers in Neurology

M1 - 35

ER -

Clinical Practice: Evidence-Based Recommendations for the Treatment of Cervical Dystonia with Botulinum Toxin

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