Muscle selection for treatment of cervical dystonia with botulinum toxin - A systematic review
Parkinsonism & Related Disorders, 07/05/2012
Nijmeijer SWR et al. – Polymyographic electromyography may improve the outcome of botulinum toxin treatment in cervical dystonia, but evidence is limited and larger studies are needed.Methods
- The authors conducted a systematic review of studies that had investigated methods of selecting muscles for treatment with botulinum toxin.
- In addition, they compared all prospective botulinum toxin trials using either clinical evaluation or polymyographic electromyography for muscle selection.
- Forty relevant studies were included and polymyographic electromyography recordings were most often employed.
- In several studies, polymyographic electromyography revealed a different pattern of muscle involvement compared to that found during clinical evaluation.
- In one randomized controlled trial polymyographic electromyography significantly improved the outcome of botulinum toxin treatment.
- A limited number of studies used positron emission tomography – computed tomography imaging or frequency analysis of the electromyography signal to identify dystonic muscles but their effect on the outcome of treatment has never been studied.