title: Elimination of dysphagia using ultrasound guidance for botulinum toxin injections in cervical dystonia.
abstract: BACKGROUND
  Dysphagia is a common side effect after botulinum toxin injections for cervical dystonia, with an incidence of 10-40%, depending upon the study and dose used.
  
  
  METHODS
  Our study consisted of 5 preselected women who met criteria for cervical dystonia and subsequent dysphagia after electromyography (EMG)-guided injections. Injections were performed with ultrasound (US) imaging, and the effects on swallowing were examined. Separately, sternocleidomastoid (SCM) thickness in healthy controls and treated patients was measured.
  
  
  RESULTS
  There were 34 episodes of dysphagia over 98 injection sessions using EMG guidance for a cumulative rate of 34.7%. Using US plus EMG guidance, there was 0% dysphagia across 27 injection sessions. SCM thickness was <1.1 cm.
  
  
  CONCLUSIONS
  US combined with EMG guidance eliminated recurrent dysphagia after botulinum toxin treatment, possibly by keeping the injectate within the SCM.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, 201 Kaufmann Building, 3471 Fifth Avenue, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Justin S
authors.initials: JS
authors.lastname: Hong
authors.forename: Geeta G
authors.initials: GG
authors.lastname: Sathe
authors.forename: Christian
authors.initials: C
authors.lastname: Niyonkuru
authors.forename: Michael C
authors.initials: MC
authors.lastname: Munin
mesh_terms: D000328:Adult; D000368:Aged; D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage; D001905:Botulinum Toxins / Q000008:administration & dosage*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D014103:Torticollis / Q000188:drug therapy*; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins