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Abstract
Purpose of review We provide a practical guide on the use of electromyography (EMG) and ultrasound (US) to assist botulinum neurotoxin (BoNT) treatment in patients with cervical dystonia (CD).
Recent findings US and EMG guidance improve BoNT treatment in CD. Their use is particularly valuable for targeting deep neck muscles and managing complex cases. There is also evidence that adverse events are reduced when superficial or intermediate layer muscles are injected with assisted guidance.
Summary A structured clinical approach, based on functional neck anatomy, guides CD assessment and BoNT treatment. Muscles are selected according to clinical, EMG and US findings. US provides anatomical visualization, while EMG complements by detecting muscle activity. We review here the current practice for assisted treatment of CD through BoNT cycles. We also describe how to recognize and manage the main adverse events.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp
- Received May 29, 2018.
- Accepted August 28, 2018.
- © 2018 American Academy of Neurology
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