Botulinum toxin therapy for cervical dystonia.

Cervical dystonia (CD) is the most common form of focal dystonia treated with botulinum toxin (BoNT) injections. BoNT has been shown in numerous clinical trials to correct the abnormal posture and movement and to markedly reduce pain associated with CD. In addition, BoNT has favorably modified the natural history of the disease by preventing contractures and other complications of CD, such as secondary degenerative changes of the cervical spine and associated radiculopathy. In a long-term follow-up of patients treated for up to 20 years, the duration of response appears to be sustained and the risk of immunoresistance due to blocking antibodies is relatively small. This review provides and update on the treatment of CD with BoNT type A (BOTOX, Dysport, Xeomin and BoNT type B (Myobloc, NeuroBloc.