Individualized Management of Cervical Dystonia with Different Serotypes of Botulinum Toxin: Recent Therapeutic Advances and Risk of Development of Neutralizing Antibodies

Kamm C, Benecke R.  Individualized Management of Cervical Dystonia with Different Serotypes of Botulinum Toxin:  Recent Therapeutic Advances and Risk of Development of Neutralizing Antibodies.  European Neurological Journal, June 2010; 2(1):  49-54

Review article


Christoph Kamm and Reiner Benecke
Affiliations: Klinik für Neurologie und Poliklinik, Universität Rostock


ABSTRACT

Cervical dystonia is the most frequent form of adult‐onset focal dystonia, characterized by abnormal head and neck posture due to involuntary contractions in a certain set of muscles, sometimes superimposed by tremulous or myoclonic movements. Intramuscular injection of botulinum toxin in carefully selected muscles is nowadays considered the first‐line treatment. For each individual patient, dosage and distribution of muscles to be injected must be accurately selected using experience‐based algorithms, also depending on the formulation of botulinum toxin chosen. This review focuses on recent therapeutic advances in this field, including discussion of recent clinical studies with both serotypes of botulinum toxin (type A and B) that are currently in clinical use. Presently available data indicate that the risk of developing neutralizing antibodies may be higher under therapy with botulinum toxin type B than with type A.

Keywords: cervical dystonia, spasmodic torticollis, botulinum toxin type A, botulinum toxin type B, clinical studies, antibody, secondary non‐responsiveness
Correspondence: Reiner Benecke, Klinik für Neurologie und Poliklinik, Gehlsheimer Str. 20, 18147 Rostock, Germany. Tel: (+49)‐381‐494‐9511; Fax: (+49)‐381‐494‐9512; e‐mail: reiner.benecke@med.uni‐rostock.de