Botulinum Toxin Injection for Torticollis, or Cervical Dystonia

• Purpose – To relax the overactive muscles in the head and neck in order to have a normal posture and relieve pain.

• Overview – Cervical dystonia is involuntary muscle spasms in the neck that cause abnormal movements and abnormal posture of the head and neck. Specifically, Torticollis is defined as the chin facing either shoulder. The injection delivers a dose of botulinum torein solution directly into the overactive muscles in the head and neck. The injection is not a cure, but therapeutically relaxes the affected muscles.

• Before the procedure – There are no special preparations before the injection.

• Details – The patient is monitored by an electromyography machine that measures muscle activity, enabling the physician to determine the muscles to inject. Once the injection site is determined, a botulinum solution is injected into the tensed muscles.

• After the procedure – There may be pain or bruising at the injection site, as well as new pain developing within the first weeks of the injection. The new pain is most likely due to the reduction of the injected muscles, or from the other muscles that may be trying to compensate the effects of the botulinum solution. Generally, pain lasts one to three weeks. To treat this pain, it is recommended to take acetaminophen and use cool compresses. Other side effects include: difficulty swallowing, neck weakness, and in rare cases, the development of generalized tiredness or  an upper respiratory infection.