Botulinum toxin therapy for cervical dystonia.

Botulinum toxin revolutionized the treatment of cervical dystonia. In contrast to systemically active medications, the effect of botulinum toxin results from selective administration to weaken muscles involved in the dystonic posturing of the head. This article reviews the pathophysiologic basis of symptoms in cervical dystonia and how botulinum toxin alleviates them. Other therapeutic options are reviewed for comparison. This article discusses strategies for maximizing the clinical benefit of botulinum toxin in this disorder and reviews muscle selection and identification with electromyography.