From the Guidelines
Botox is best for cervical dystonia, as it is effective in treating involuntary contractions of the neck and upper shoulder muscles, resulting in abnormal postures or movements of the neck, shoulders, and head. The treatment of cervical dystonia with Botox has been established, with all FDA-approved formulations of botulinum neurotoxin being commonly used, despite differing evidence levels 1.
Key Points for Botox Treatment
- All FDA-approved formulations of botulinum neurotoxin, including OnaBoNT-A and incoBoNT-A, are equally effective and should be considered for treatment of cervical dystonia 1.
- AboBoNT-A and rimaBoNT-B are similarly effective and should be offered for the treatment of cervical dystonia 1.
- Botox is also effective in treating upper and lower limb spasticity in adults, reducing muscle tone and improving passive function, and is possibly effective for improving active function 1.
Administration and Effects
When administering Botox for cervical dystonia, the injections are targeted at specific muscle groups involved in the abnormal postures or movements. Patients should expect some mild discomfort during injection and possible temporary weakness in the affected muscles. Botox works by blocking the release of neurotransmitters involved in muscle contraction, effectively reducing the involuntary contractions that contribute to the abnormal postures or movements characteristic of cervical dystonia. Results typically begin to appear within 1-2 weeks after injection and may last for several months.
From the Research
Calagia and Botox
- Botox is best for treating benign essential blepharospasm, a type of Calagia characterized by involuntary spasmodic bilateral closing of the eyelids 2, 3, 4.
- The symptoms of benign essential blepharospasm are typically triggered by stress, fatigue, intense light, or individual factors, and the disease is usually slowly progressive 2.
- Botox administration has been an effective treatment for benign essential blepharospasm and should be considered the first choice for this condition 2, 4.
- Other types of Calagia, such as hemifacial spasm, can also be treated with Botox, although the treatment approach may differ 3.
Treatment Approaches
- For benign essential blepharospasm, Botox is typically administered in doses ranging from 10-30 units per eye, with an average effective duration of 2-3 months 4.
- In some cases, patients may require higher doses of Botox over time to maintain efficacy 4.
- For patients who become refractory to Botox, alternative treatments such as Myobloc (botulinum toxin B) may be effective, although side effects may be more common 5.
- Other botulinum toxin products, such as Dysport, have also been shown to be effective and safe for the treatment of benign essential blepharospasm 6.