title: Head and neck muscle spasm after radiotherapy: management with botulinum toxin A injection.
abstract: OBJECTIVE
  To introduce the concept of neck muscle pain and spasm after radiotherapy and its treatment with botulinum toxin A.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Ambulatory patients at a tertiary care medical center.
  
  
  METHODS
  Individuals who had undergone primary or adjuvant radiotherapy for treatment of carcinoma of the head and neck were asked about painful spasms of the neck musculature. A volunteer sample was used. If they desired treatment with botulinum toxin A, they were included in the study.
  
  
  METHODS
  Patients received botulinum toxin A injections to the affected sternocleidomastoid muscle(s) in 1 or 2 locations.
  
  
  METHODS
  Subjective pain relief.
  
  
  RESULTS
  Four of 6 patients with painful tightness of the neck who received botulinum toxin A injections to the sternocleidomastoid muscle achieved pain relief.
  
  
  CONCLUSIONS
  A subset of patients with irradiation-induced cervical muscle spasm benefit from treatment with botulinum toxin A injections. Further study is needed to more clearly define the entity and treatment.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Health Care, Iowa City 52242, USA. douglas-van-daele@uiowa.edu
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Van Daele
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Finnegan
authors.forename: Robert L
authors.initials: RL
authors.lastname: Rodnitzky
authors.forename: Weining
authors.initials: W
authors.lastname: Zhen
authors.forename: Timothy M
authors.initials: TM
authors.lastname: McCulloch
authors.forename: Henry T
authors.initials: HT
authors.lastname: Hoffman
mesh_terms: D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000187:drug effects* / Q000528:radiation effects*; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D010147:Pain Measurement; D011878:Radiotherapy / Q000009:adverse effects*; D013035:Spasm / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A