Sonographic Guide for Botulinum Toxin Injections of the Neck Muscles in Cervical Dystonia

Bayram Kaymak; Murat Kara; Eda Gürçay; Levent Özçakar

doi:10.1016/j.pmr.2017.08.009

Sonographic Guide for Botulinum Toxin Injections of the Neck Muscles in Cervical Dystonia

Phys Med Rehabil Clin N Am. 2018 Feb;29(1):105-123. doi: 10.1016/j.pmr.2017.08.009.

Authors

Bayram Kaymak¹, Murat Kara¹, Eda Gürçay², Levent Özçakar³

Affiliations

¹ Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey.
² Department of Physical and Rehabilitation Medicine, Gaziler Training and Research Hospital, Lodumlu yolu, 06800 Bilkent, Ankara, Turkey.
³ Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey. Electronic address: lozcakar@yahoo.com.

PMID: 29173657
DOI: 10.1016/j.pmr.2017.08.009

Abstract

Intramuscular botulinum toxin (BoTX) injection is the first-line treatment of cervical dystonia. Poor treatment outcomes and some side effects, however, have been reported after BoTX applications. One of the most important reasons is incorrect localization of the needle during toxin injections. Without imaging, it is impossible to verify precise needle positioning in the proper muscle. Ultrasound has been recommended because of its high capability in illustrating most of the neck muscles. This review article discusses how ultrasound imaging can be used to scan/access neck muscles, mainly from the perspective of BoTX injections.

Keywords: Botulinum toxin; Cervical dystonia; Innervation zone; Muscle; Ultrasound.

Publication types

Review

MeSH terms

Botulinum Toxins / administration & dosage*
Humans
Neck Muscles / diagnostic imaging*
Neck Muscles / drug effects
Neuromuscular Agents / administration & dosage*
Torticollis / diagnostic imaging*
Torticollis / drug therapy*
Ultrasonography, Interventional* / methods

Substances

Neuromuscular Agents
Botulinum Toxins