Examination and Treatment of Complex Cervical Dystonia

Abstract

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In cervical dystonia (CD), outcome of treatment with botulinum neurotoxin (BoNt), is highly dependent on the correct identificationof the muscles involved. There are “simple” (in one plane) and “complex” (in two or more levels) forms of CD. The difficulty lies in the treatment of complex CD, requiring a more extensive analysis. For such analysis, different diagnostic methods are used. These include: ultrasound, CT neck soft tissue imaging (particularly the deep muscles of the neck), electromyography (EMG) of neck muscles, and standardized photographs of patients with measurements of angles (head, neck, thorax).