CT-guided intramuscular botulinum toxin A injections into the deep anterior neck muscles in patients with pure antecaput or antecollis

Aim of the studyTo demonstrate the influence of botulinum toxin (BTX) type A injections into the deep anterior neck muscles (aDNMs) on the severity of cervical dystonia (CD) in severely affected CD-patients with pure antecaput and/or antecollis.MethodsRetrospective analysis of our (Access) data bank and the CT-scans performed during injections.In eight patients CT-guided injections were performed. Outcome was measured by means of the TSUI-score and a 4 point global assessment scale (GAS) to score efficacy, tolerability and pain relief of BTX-A injections into the aDNMs. Patients were asked for side effects of the injections.ResultsRetrospective analysis reveals that CT-guided intramuscular injections of BTX-A into the aDNMs improve antecollis better than antecaput and reduce pain, but are tolerated barely. The most frequent side-effects were dysphagia and anxiety. The majority of patients wanted to be reinjected.ConclusionFor the special subgroup of CD-patients with a severe antecollis CT-guided injections of the aDNMs are a relevant treatment option for intermittent but not continuous intervention.