Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-pftt2 Total loading time: 0 Render date: 2024-04-30T17:42:13.282Z Has data issue: false hasContentIssue false

Chapter 7 - Ultrasound guidance for botulinum neurotoxin therapy: cervical dystonia

Published online by Cambridge University Press:  05 February 2014

By
Katharine E. Alter
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett  and
Christopher Zachary
Katharine E. Alter
Affiliation:
Mount Washington Pediatric Hospital, Baltimore, MD, USA
Daniel Truong
Affiliation:
The Parkinson’s and Movement Disorders Institute, Fountain Valley, California
Dirk Dressler
Affiliation:
Department of Neurology, Hannover University Medical School
Mark Hallett
Affiliation:
George Washington University School of Medicine and Health Sciences, Washington, DC
Christopher Zachary
Affiliation:
Department of Dermatology, University of California, Irvine
Get access

Summary

Introduction

The primary focus of this chapter is to provide a review of the technical requirements and techniques for performing brightness mode (B-mode) ultrasound (US) to guide botulinum neurotoxin (BoNT) injections for cervical dystonia (CD). A brief review of the advantages and disadvantages of various guidance techniques and the supporting literature is also presented.

Cervical dystonia

Idiopathic CD is the most common form of focal dystonia worldwide (Defazio et al., 2004; Jankovic, 2004). It is characterized by sustained muscle contraction leading to abnormal postures and twisting movements of the head and neck. Patients with CD report functional limitations and pain associated with the muscle pulling or twisted postures. The combination of pain and posturing affect many activities of daily living and quality of life and limit participation in work, family life and avocational interests. A full review of the diagnosis, patterns of muscle involvement and range of therapies for CD is covered elsewhere in this text.

Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 46 - 59
Publisher: Cambridge University Press
Print publication year: 2014

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alter, KE (2010). High-frequency ultrasound guidance for neurotoxin injections. Phys Med Rehabil Clin N Am, 21, 607–30.CrossRefGoogle ScholarPubMed
Alter, KE, Hallett, M, Karp, B (eds.) (2012). Ultrasound Guided Chemodenervation Procedures. Text and Atlas. New York: Demos Medical, pp. 84–107.
Boon, AJ, Oney-Marlow, TM, Murthy, NS et al. (2011). Accuracy of electromyography needle placement in cadavers: non-guided vs. ultrasound guided. Muscle Nerve, 44, 45–9.CrossRefGoogle ScholarPubMed
Botwin, KP, Sharma, K, Saliba, R, Patel, BC (2008). Ultrasound-guided trigger point injections in the cervicothoracic musculature: a new and unreported technique. Pain Physician, 11, 885–9.Google ScholarPubMed
Brans, JW, Lindeboom, R, Snoek, JW et al. (1996). Botulinum toxin versus trihexyphenidyl in cervical dystonia: a prospective, randomized, double-blind controlled trial. Neurology, 46, 1066–72.CrossRefGoogle ScholarPubMed
Brashear, A, Lew, MF, Dykstra, DD et al. (1999). Safety and efficacy of NeuroBloc (botulinum toxin type B) in type A-responsive cervical dystonia. Neurology, 53, 1439–6.CrossRefGoogle ScholarPubMed
Comella, CL, Tanner, CM, DeFoor-Hill, L, Smith, C (1992). Dysphagia after botulinum toxin injections for spasmodic torticollis: clinical and radiologic findings. Neurology, 42, 1307–10.CrossRefGoogle ScholarPubMed
Comella, CL, Jankovic, J, Truong, DD, Hanschmann, A, Grafe, S (2011). US. XEOMIN Cervical Dystonia Study Group. Efficacy and safety of incobotulinumtoxinA (NT 201, XEOMINVR, botulinum neurotoxin type A, without accessory proteins) in patients with cervical dystonia. J Neurol Sci, 308, 103–9.CrossRefGoogle Scholar
Costa, J, Espírito-Santo, C, Borges, A et al. (2005). Botulinum toxin type B for cervical dystonia. Cochrane Database Syst Rev, (1), CD004315.Google Scholar
Danielson, K, Odderson, IR (2008). Botulinum toxin type A improves blood flow in vascular thoracic outlet syndrome. Am J Phys Med Rehabil, 87, 956–9.CrossRefGoogle ScholarPubMed
Davidson, J, Jayaraman, S (2011). Guided interventions in musculoskeletal ultrasound: what’s the evidence?Clin Radiol, 66, 140–52.CrossRefGoogle ScholarPubMed
Defazio, G, Abbruzzese, G, Livrea, P, Berardelli, A (2004). Epidemiology of primary dystonia. Lancet Neurol, 3, 673–8.CrossRefGoogle ScholarPubMed
Elovic, EP, Esquenazi, A, Alter, KE et al. (2009). Chemodenervation and nerve blocks in the diagnosis and management of spasticity and muscle overactivity. PM R, 1, 842–51.CrossRefGoogle ScholarPubMed
Glass, GA, Ku, S, Ostrema, JL et al. (2009). Fluoroscopic, EMG-guided injection of botulinum toxin into the longus collifor the treatment of anterocollis. Parkinsonism Relat Disord, 15, 610–13.CrossRefGoogle ScholarPubMed
Henzel, KM, Munin, MC, Kiyonkuru, C et al. (2010). Comparison of surface and ultrasound localization to identify forearm flexor muscles for botulinum toxin therapy. PM R, 2, 642–6.CrossRefGoogle Scholar
Hong, JS, Sathe, GG, Niyonkuru, C et al. (2012). Elimination of dysphagia using ultrasound guidance for botulinum toxin injections in cervical dystonia. Muscle Nerve, 46, 535–9.CrossRefGoogle ScholarPubMed
Jankovic, J (2004). Treatment of cervical dystonia. In Brin, MF, Comella, CL, Jankovic, J (eds.) Dystonia: Etiology, Clinical Features, and Treatment. Philadelphia, PA: Lippincott, Williams & Wilkins, pp. 159–66.Google Scholar
Jordan, SE, Ahn, SS, Gelabert, HA (2007). Combining ultrasonography and electromyography for botulinum chemodenervation treatment of thoracic outlet syndrome: comparison with fluoroscopy and electromyography guidance. Pain Physician 10, 541–6.Google ScholarPubMed
Kwon, JY, Hwang, JH, Kim, JS (2010). Botulinum toxin A injection into calf muscles for treatment of spastic equinus in cerebral palsy: a controlled trial comparing sonography and electric stimulation-guided injection techniques: a preliminary report. Am J Phys Med Rehabil, 89, 279–86.CrossRefGoogle ScholarPubMed
Lee, IH, Yoon, YC, Sung, DH, Kwon, JW, Jung, JY (2009). Initial experience with imaging-guided intramuscular botulinum toxin injection in patients with idiopathic cervical dystonia. AJR Am J Roentgenol, 192, 996–1001.CrossRefGoogle ScholarPubMed
Lim, EC, Quek, AM, Seet, RC (2011). Accurate targeting of botulinum toxin injections: how to and why. Parkinsonism Relat Disord, 17(Suppl 1), S34–9.CrossRefGoogle Scholar
Molloy, FM, Shill, HA, Kaelin-Lang, A, Karp, BI (2002). Accuracy of muscle localization without EMG: implications for treatment of limb dystonia. Neurology, 58, 805–7.CrossRefGoogle ScholarPubMed
Peck, E, Finnoff, JT, Smith, J et al. (2011). Accuracy of palpation-guided and ultrasound-guided needle tip placement into the deep and superficial posterior leg compartments. Am J Sports Med, 39, 1968–74.CrossRefGoogle ScholarPubMed
Picelli, A, Tamburin, S, Bonetti, P et al. (2012). Botulinum toxin type A injection into the gastrocnemius muscle for spastic equinus in adults with stroke: a randomized controlled trial comparing manual needle placement, electrical stimulation and ultrasonography-guided injection techniques. Am J Phys Med Rehabil, 91, 957–64.CrossRefGoogle ScholarPubMed
Schnitzler, A, Roche, N, Denormandie, P et al. (2012) Manual needle placement: accuracy of botulinum toxin A injections. Muscle Nerve, 46, 531–4.CrossRefGoogle ScholarPubMed
Simpson, DM, Blitzer, A, Brashear, A et al. (2008). Assessment: botulinum neurotoxin for the treatment of movement disorders (an evidence-based review). Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 70, 1699–706.CrossRefGoogle ScholarPubMed
Simpson, DM, Gracies, JM, Graham, K et al. (2009). Assessment: botulinum neurotoxin for the treatment of spasticity (an evidence-based review). Neurology, 73, 736–7; author reply, 737–8.Google Scholar
Smith, J, Finnoff, JT (2009a). Diagnostic and interventional musculoskeletal ultrasound: part 1. Fundamentals. PM R, 1, 64–75.CrossRefGoogle ScholarPubMed
Smith, J, Finnoff, JT (2009b). Diagnostic and interventional musculoskeletal ultrasound: part 2. Clinical applications. PM R, 1, 162–77.CrossRefGoogle ScholarPubMed
Speelman, JD, Brans, JW (1995). Cervical dystonia and botulinum treatment: is electromyographic guidance necessary?Mov Disord, 10, 802.CrossRefGoogle ScholarPubMed
Torriani, M, Gupita, R, Donahue, DM (2010). Botulinum toxin injection in neurogenic thoracic outlet syndrome: results and experience using a ultrasound-guided approach. Skeletal Radiol, 39, 973–80.CrossRefGoogle ScholarPubMed
Truong, D, Lewitt, P, Cullis, P (1989). Effects of different injection techniques in the treatment of torticollis with botulinum toxin. Neurology, 39(Suppl), 294.Google Scholar
Truong, D, Brodsky, M, Lew, M et al. (2010). Long-term efficacy and safety of botulinum toxin type A (Dysport) in cervical dystonia. Parkinsonism Relat Disord, 16, 316–23.CrossRefGoogle Scholar
Useros-Olmo, AI, Collado-Vázquez, S. (2010). Effects of an hydrotherapy program in the treatment of cervical dystonia. A pilot study. Rev Neurol, 51, 669–76.Google ScholarPubMed
Yang, EJ, Rha, DW, Yoo, JK, Park, ES (2009). Accuracy of manual needle placement for gastrocnemius muscle in children with cerebral palsy checked against ultrasonography. Arch Phys Med Rehabil, 90, 741–4.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×