ReviewPractical neurology2016
British Neurotoxin Network recommendations for managing cervical dystonia in patients with a poor response to botulinum toxin.
Review in Practical neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed.
- Trial
- A simplified ultrasonography-guided approach for neurotoxin injection into the obliquus capitis inferior muscle in spasmodic torticollis.Journal of neural transmission (Vienna, Austria : 1996) · 2018Trial
- Personalized botulinum toxin type A therapy for cervical dystonia based on kinematic guidance.Journal of neurology · 2018Trial
- Review
- Patient Perceptions of a Preventive Effect of Long-Term Botulinum Neurotoxin Therapy in Cervical Dystonia.Toxins · 2026Article
- Article
- Exploring Nonresponse to Botulinum Toxin in Aesthetics: Narrative Review of Key Trigger Factors and Effective Management Strategies.JMIR dermatology · 2025Review
- Review
- Management of Secondary Poor Response to Botulinum Toxin in Cervical Dystonia: A Multicenter Audit.Movement disorders clinical practice · 2021Article
- Ultrasound Study to Validate the Anterior Cervical Approach to the Longus Colli Muscle Using Electromyography Control Alone.Tremor and other hyperkinetic movements (New York, N.Y.) · 2020Article
- Association Between Secondary Botulinum Toxin A Treatment Failure in Cosmetic Indication and Anti-Complexing Protein Antibody Production.Dermatology and therapy · 2020Article
- Management of cervical dystonia with botulinum neurotoxins and EMG/ultrasound guidance.Neurology. Clinical practice · 2019Review
- Cervical dystonia: Injecting botulinum neurotoxin into semispinalis capitis improves goose-neck posture.Clinical parkinsonism & related disorders · 2019Article
- Spectrum of practice in the routine management of cervical dystonia with abobotulinumtoxinA: findings from three prospective open-label observational studies.Journal of clinical movement disorders · 2018Article
- Key Parameters for the Use of AbobotulinumtoxinA in Aesthetics: Onset and Duration.Aesthetic surgery journal · 2017Review
- Clinical guidelines: No more mistaken identities for botulinum neurotoxins.Nature reviews. Neurology · 2016Article
- Pharmacological differences and clinical implications of various botulinum toxin preparations: a critical appraisal.Functional neurologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Botulinum toxin (BoNT) injections are an effective treatment for cervical dystonia. Approximately 20% of patients eventually stop BoNT treatment, mostly because of treatment failure. These recommendations review the different therapeutic interventions for optimising the treatment in secondary poor responder patients. Immunoresistance has become less common over the years, but the diagnosis has to be addressed with a frontalis test or an Extensor Digitorum Brevis test. In case of immunoresistance to BoNT-A, we discuss the place the different therapeutic options (BoNT-A holidays, BoNT-B injections, alternative BoNT-A injections, deep brain stimulation). When poor responders are not immunoresistant, they benefit from reviewing (1) injections technique with electromyography or ultrasound guidance, (2) muscles selection and (3) dose of BoNT. In addition, in both scenarios, a holistic approach including drug treatment, retraining and psychological support is valuable in the management of these complex and severe cervical dystonia.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.