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Chapter 7 - Ultrasound Guidance for Botulinum Neurotoxin Therapy

Cervical Dystonia

Published online by Cambridge University Press:  02 November 2023

By
Panagiotis Kassavetis ,
Michael E. Farrell  and
Katharine E. Alter
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
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Summary

Idiopathic cervical dystonia (CD) is characterized by sustained muscle contraction leading to abnormal postures and twisting movements of the head and neck. BoNT is the gold standard for treatment of the abnormal postures and movements associated with CD. It provides a long duration of symptomatic relief of the pain or postures associated with CD with minimal side effects.

The complex regional anatomy in the craniocervical region increases the potential risks of injections in this area. Ultrasound guidance provides useful information about the depth and thickness of the target muscles, structures to be avoided when inserting/advancing a needle, a safe path to the target and the location of the injectate within the muscle. When treating patients with CD, ultrasound is frequently combined with EMG guidance which provides additional information about muscle activity and potential contribution to a posture. This chapter provides a review of ultrasound guidance for injections for craniocervical dystonia

Keywords

Cervical dystoniabotulinum toxinBoNTultrasound guidancechemodenervationlinear transducerB-mode US imagingsternocleidomastoidlongus collilongus capitisscalene compleslevator scapulaesplenius capitistrapeziussemispinalis capitisLongissimus capitis
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 48 - 57
Publisher: Cambridge University Press
Print publication year: 2023

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References

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