Abstract
<strong>Background:</strong> Anterior forms of cervical dystonia are considered to be the most difficult to treat because of the deep cervical muscles that can be involved. <strong>Case Report:</strong> We report the case of a woman with cervical dystonia who presented with anterior sagittal shift, which required injections through the longus colli muscle to obtain a satisfactory outcome. The approach via the thyroid gland was chosen. <strong>Discussion:</strong> The longus colli muscle can be injected under electromyography (EMG), computed tomography (CT), ultrasonography (US), or endoscopy guidance. We recommend using both ultrasonography and electromyography guidance as excellent complementary techniques for injection at the C5-C6 level.
Highlights
Anterior forms of cervical dystonia are considered to be the most difficult to treat because of the deep cervical muscles that can be involved
We find that longus colli (LCo) injections with fluoroscopy,[16] computed tomography (CT),[17,18] electromyography (EMG)[19] or ultrasonography (US) guidance[20] give satisfying results
Botulinum neurotoxin (BoNT) injections are the first-line of treatment for Cervical dystonia (CD) with a high response rate and low incidence of adverse effects.[3,4,5,6,7,8,9,10,11,12]
Summary
Cervical dystonia (CD) is the most common form of focal dystonia in adults,[1] characterized by involuntary sustained or intermittent neck- muscle contractions, resulting in abnormal phasic or tonic movements or posture of the head.[2]. On the basis of the Col-Cap concept, we should choose the muscles involved in these two forms of CD.[22] We can find another suggestion based on EMG functional guidance and inject both SCM and splenius capitis muscles.[19] We will describe an injection into the longus colli muscles via the thyroid gland in a patient with ASS. The patient underwent several treatment sessions with BoNT injections into her neck muscles under EMG and/or US control without any significant improvement. She had Tremor and Other Hyperkinetic Movements http://www.tremorjournal.org
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