title: Pain Relief in Cervical Dystonia with Botulinum Toxin Treatment.
abstract: Dystonia is a neurological disorder characterized by intermittent or sustained muscle contractions that cause abnormal, usually repetitive, movements and postures. Dystonic movements can be tremulous and twisting and often follow a pattern. They are frequently associated with overflow muscle activation and may be triggered or worsened by voluntary action. Most voluntary muscles can be affected and, in the case of the neck muscles, the condition is referred to as cervical dystonia (CD), the most common form of dystonia. The high incidence of pain distinguishes CD from other focal dystonias and contributes significantly to patient disability and low quality of life. Different degrees of pain in the cervical region are reported by more than 60% of patients, and pain intensity is directly related to disease severity. Botulinum toxin (BoNT) is currently considered the treatment of choice for CD and can lead to an improvement in pain and dystonic symptoms in up to 90% of patients. The results for BoNT/A and BoNT/B are similar. The complex relationship between pain and dystonia has resulted in a large number of studies and more comprehensive assessments of dystonic patients. When planning the application of BoNT, pain should be a key factor in the choice of muscles and doses. In conclusion, BoNT is highly effective in controlling pain, and its analgesic effect is sustained for a long time in most CD patients.
authors.affiliation: Neurology Service, Department of Medicine, Hospital Universitário, State University of Ponta Grossa, Ponta Grossa 84040-180, Brazil. chcamargo@uol.com.br.|Movement Disorders Unit, Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba 80060-900, Brazil. chcamargo@uol.com.br.
authors.forename: Carlos Henrique Ferreira
authors.initials: CH
authors.lastname: Camargo
authors.affiliation: Neurology Service, Department of Medicine, Hospital Universitário, State University of Ponta Grossa, Ponta Grossa 84040-180, Brazil. hagteive@mps.com.br.|Movement Disorders Unit, Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba 80060-900, Brazil. hagteive@mps.com.br.
authors.forename: Lígia
authors.initials: L
authors.lastname: Cattai
authors.affiliation: Movement Disorders Unit, Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba 80060-900, Brazil. hagteive@mps.com.br.
authors.forename: Hélio Afonso Ghizoni
authors.initials: HA
authors.lastname: Teive
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D059408:Pain Management; D014103:Torticollis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy
chemical_list: D000700:Analgesics; D001905:Botulinum Toxins
keywords: botulinum toxin; cervical dystonia; pain; treatment