RT Journal Article
SR Electronic
T1 Management of cervical dystonia with botulinum neurotoxins and EMG/ultrasound guidance
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP 64
OP 73
DO 10.1212/CPJ.0000000000000568
VO 9
IS 1
A1 Anna Castagna
A1 Alberto Albanese
YR 2019
UL http://cp.neurology.org/content/9/1/64.abstract
AB 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.