High-dose treatment with botulinum toxin A in cervical dystoniain

Injections with botulinum toxin A (BTX A)are considered as the treatment of choice in cervical dystonia. However, high dose treatment and short injections intervals are thought to be risk factors for the development of side effects and BTX A antibodies. In the following we report on the treatment of 3 patients with cervical dystonia unresponsive to commonly used doses of BTX A. All patients were clear of BTX antibodies. The first patient a 35-year old man attended our clinic with a severe spasmodic torticollis. His head turned to the right side and he showed a mild no-no tremor. He rated his pain with 85 on a vi…