Ultrasound and Electromyography as Guidance Tools for the Botulinum Toxin Therapy in Cervical Dystonia

G Salazar,S Ferreiro,M Fragoso,J Codas,H Cruz

doi:10.4236/jbbs.2021.112004

Abstract

Cervical Dystonia (CD) is the most common type of focal dystonia in the movement disorders units of any specialized hospital around the world. Botulinum Toxin (BT) infiltration is the treatment of choice for CD, according to most of the experts around the world, however the efficacy and tolerance of BT therapy in CD depend on the accuracy when BT is released into the muscles. We reviewed the medical literature in regard to the use of guiding tools for the BT infiltration in CD patients. Results: The use of guiding tools such as Ultrasound or EMG definitely improves the accuracy for releasing the BT into the muscles involved according to some authors. Conclusion: the use of Ultrasound and EMG improves the efficacy and reduce the adverse effects in the BT therapy in CD patients.

Highlights

Cervical Dystonia (CD) is the most common type of dystonia attended in the movement disorders units around the world [1] [2]
We reviewed the medical literature in regard to the use of guiding tools for the Botulinum Toxin (BT) infiltration in CD patients
We review in this article some of these techniques used nowadays as guiding tools in the BT infiltration in CD patients and describe the advantages and disadvantages of all of them

Summary

Introduction

Cervical Dystonia (CD) is the most common type of dystonia attended in the movement disorders units around the world [1] [2]. Botulinum Toxin (BT) infiltrations have shown to improve the abnormal posture and reduce the pain related to the CD [3] [4] [5]. The efficacy and the adverse effects of the BT therapy in CD depend on the accuracy when the BT is released in the muscles involved in the abnormal movements [6] [7] [8] [9]. The efficacy of BT infiltration depends on the use of guiding tools such as Ultrasound, EMG or electrical stimulation in order to improve the accuracy in the muscles involved [9] [10] [11] [12]; there is few infor-

Salazar et al DOI

EMG as Guidance in the Botulinum Toxin Infiltration in Cervical Dystonia

Ultrasound as a Guidance Tool in Cervical Dystonia

Findings

Discussion

Conclusion