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Patient considerations in the treatment of cervical dystonia: focus on botulinum toxin type A

Authors Mills R, Pagan F

Received 7 October 2014

Accepted for publication 12 February 2015

Published 2 June 2015 Volume 2015:9 Pages 725—731

DOI https://doi.org/10.2147/PPA.S75459

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen

Reversa R Mills, Fernando L Pagan

Department of Neurology, Movement Disorders and Neurorestoration Division, Georgetown University Hospital, Washington, DC, USA

Abstract: Cervical dystonia is the most common form of focal dystonia characterized by involuntary muscle contractions causing abnormal movements and posturing of the head and neck and is associated with significant pain. Botulinum toxin is considered first-line therapy in the treatment of pain and abnormal head posturing associated with cervical dystonia. There are currently three botulinum toxin type A neurotoxins and one botulinum type B neurotoxin commercially available and US Food and Drug Administration (FDA) labeled for the treatment of cervical dystonia. This review will focus on the efficacy, safety, and therapeutic use of botulinum type A neurotoxins in the treatment of cervical dystonia. We conclude with a discussion of factors influencing toxin selection including therapeutic effect, duration of effect, side effect profile, cost, and physician preference.

Keywords: spasmodic torticollis, neurotoxin, pain, onabotulinumtoxinA, abobotulinumtoxinA, incobotulinumtoxinA

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