Cervical Dystonia

Approaches to Treatment with Botulinum Toxin Type A

Injections of botulinum toxin type A (BoNT-A) have been used in the management of dystonia since the late 1980s. BOTOX® (onabotulinumtoxinA, Allergan, Inc.) was approved in the United States by the FDA in 1989 for use in patients ages 12 and above who were affected by strabismus, blepharospasm associated with dystonia–including benign essential blepharospasm–or disorders of the seventh cranial nerve. Since then, BoNT-A has been demonstrated to be safe and effective in the management of focal dystonias, as well as other disorders characterized by excessive involuntary muscle spasms.

On December 27, 2000, the FDA approved the use of BOTOX® for the treatment of cervical dystonia (CD). Injections of this product decrease the severity of abnormal head positioning and postures as well as associated neck pain. In 2009, the FDA approved another botulinum toxin type A product, Dysport® (abobotulinumtoxinA, Ipsen Ltd), for treatment of cervical dystonia. In August of 2010, the FDA approved a third BoNT-A product, Xeomin® (incobotulinumtoxinA) for treatment of cervical dystonia and blepharospasm.