47-year-old female with neck problems underwent Blink Reflex tests and EMG of the neck, and was diagnosed with cervical dystonia. Medical treatments available for cervical dystonia include anticholinergic therapy, Baclofen, or deep brain stimulation, but the mainstay of therapy remains botulinum toxin injections, which are considered the superior treatment for symptom control with less side effects in comparison to oral medications.
53-year-old male with lower motor neuropathy affecting all 4 limbs. The neurologic examination showed left limb hyposthenia, left upper limb hypotrophy and diffuse fasciculations. The patient was diagnosed with “suspect motor neuron disease" and was treated with IVIG cycles with slight initial improvement, but later lack of response and worsening of the clinical condition.
47-year-old female with a 4-year history of cervical dystonia. She has been treated with botulinum toxin injections which were ineffective for her. In the expert's opinion, the success of Botulinum toxin in cervical dystonia depends on a thorough clinical assessment, exact targeting of the chosen muscles, and adequate doses of toxin injected. The expert also suggests additional or alternative treatment strategies: medical treatment by different oral drugs, or deep brain stimulation of the globus pallidus interna.