Change of the nature of dystonic hyperkinesis in patients suffering from spasmodic torticollis following recurrent injections of botulotoxin A

The data of the 6-year follow-up of 101 patients with spasmodic torticollis (ST) receiving regular treatment with botulotoxin type A (BTA) in Belarus are presented. The comparison group comprised 74 patients suffering from ST and receiving traditional therapy without BTA. Stable positive effect of BTA on repeat injections every 6–10 months was revealed. On this background, the amount of combined forms of ST, as well as the number of cases of retro- and laterokollis, increased, and a part of the patients displayed the «bayonet» symptom. Change in the head posture required changes in the selection of target muscles for BTA injection. Clinical example of high efficacy of longterm therapy with 8 consecutive injections is presented. Even with long intervals (9–18 months) between repeat BTA injections, the degree of ST severity did not reach the initial values.