title: A pilot study of botulinum toxin A for headache in cervical dystonia.
abstract: OBJECTIVE
  To evaluate the prevalence of associated headache (HA) pain with craniocervical dystonia and the therapeutic effect of BoNT-A injections on the HA component when injected for cervical dystonia.
  
  
  BACKGROUND
  HA associated with craniocervical dystonia is a recent formally codified entity, but has not been systematically studied.
  
  
  METHODS
  We identified 44 subjects from three movement disorder clinics who presented with craniocervical dystonia and concurrent HA pain. The subjects were injected with botulinum toxin type A (BoNT-A) and prospectively evaluated with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), headache diaries, Headache Impact Test (HIT-6), and Migraine Disability Assessment Scale (MIDAS), along with HA pain anatomy and adverse events, at baseline, and at 4, 8, and 12 weeks post-injection.
  
  
  RESULTS
  As expected, all aspects of the TWSTRS robustly improved. Headache diaries and the HIT-6 also improved at 4, 8, and 12 weeks post-injection. Sections of the MIDAS improved, and adverse events were minimal.
  
  
  CONCLUSIONS
  BoNT-A safely improves headache associated with craniocervical dystonia when administered for the primary condition of craniocervical dystonia.
authors.affiliation: Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: William G
authors.initials: WG
authors.lastname: Ondo
authors.forename: Stephen
authors.initials: S
authors.lastname: Gollomp
authors.forename: Nestor
authors.initials: N
authors.lastname: Galvez-Jimenez
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D020773:Headache Disorders / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use; D010865:Pilot Projects; D011446:Prospective Studies; D014103:Torticollis / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A