Medical University of Gdansk, Poland, Gdansk, Poland.
Parkinson-Klinik Ortenau, Wolfach, Germany, Germany.
Neurol Neurochir Pol. 2021;55(2):125-132. doi: 10.5603/PJNNS.a2021.0029. Epub 2021 Apr 6.
Cervical dystonia (CD) usually presents a complex pattern of head/neck movements accompanied by tremor, myoclonic jerks and a wide spectrum of non-motor disturbances such as pain, depression, anxiety, and sleep problems. This is the most challenging indication for botulinum neurotoxin (BoNT) treatment. It can offer significant improvement, but it can be difficult after the first injection. Thorough examination and identification of the proper CD pattern, the identification of the muscles responsible, and adjusting doses given precisely under ultrasound and/or electromyographic guidance seem to be the key success modifiers. Nevertheless, this is a lifelong treatment and should be planned and conducted carefully to avoid failures and drop outs. The aim of this paper was to examine the current concepts in terms of anatomy, physiology and CD patterns (Col-Cap concept) as well as the proper dosages and any possible obstacles impeding successful treatment.
颈部肌张力障碍 (CD) 通常表现为头部/颈部运动的复杂模式，伴有震颤、肌阵挛性抽搐以及广泛的非运动障碍，如疼痛、抑郁、焦虑和睡眠问题。这是肉毒毒素 (BoNT) 治疗最具挑战性的适应症。它可以提供显著的改善，但在第一次注射后可能会变得困难。彻底检查和识别适当的 CD 模式、识别负责的肌肉以及在超声和/或肌电图引导下精确调整剂量似乎是关键的成功因素。然而，这是一种终身治疗，应仔细计划和进行，以避免失败和脱落。本文的目的是检查当前在解剖学、生理学和 CD 模式方面的概念（Col-Cap 概念）以及适当的剂量和任何可能阻碍成功治疗的障碍。
