Cervical Dystonia

Injection of Botulinum Toxin Type B

During the administration of botulinum toxin type B, a relatively small needle is placed into the target muscle. In large or accessible muscles, confirmation of appropriate placement of the injection into the target muscle may be achieved by feeling the muscle. In small or deep muscle groups, electromyography (EMG) or electrical stimulation may be required to confirm appropriate placement.

Small muscles may be injected in only one or two sites. Larger muscles may require three to four injection sites. Most individuals are able to tolerate these small needle punctures; however, if necessary, local anesthetic cream or sedation may help ease discomfort or anxiety associated with injection. This may be particularly useful for children who are receiving injections.

Vials of MYOBLOC may be stored at 2 degrees to 8 degrees Centigrade for up to 21 months. In order to preserve the integrity of the toxin, vials should not be frozen or shaken. MYOBLOC may be diluted with sterile saline (without preservative). Because the volume in the vials is greater than the nominal volume, dilution should be performed in the syringe, not in the vial. Diluted toxin should be used within four hours.