Botox For Cervical Dystonia: Dysport, Xeomin And Myobloc Reviewed

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Botox injections are a popular option to treat cervical dystonia. Botox is used because it contains botulinum toxin.

Doctor Medica team

Botox injections are a popular option to treat cervical dystonia. Botox is used because it contains botulinum toxin. Medical professionals around the world use similar products as well like Xeomin, Dysport and Myobloc.

Botulinum Toxin (BT) Therapy

The first study demonstrating the efficacy of BT type A in cervical dystonia was published in 1986. Subsequent studies have confirmed its efficacy and safety for multiple forms of dystonia, apart from CD. Denervation of the affected muscle using botulinum toxin injectables has become the treatment of choice for cervical dystonia. It has dramatically improved the prognosis and quality of life of patients with CD.

Botulinum toxin prevents neuromuscular transmission resulting in weakness of the targeted muscle. This is done by inhibiting the release of acetylcholine from nerve terminals. After injection of botulinum toxin, patients may experience clinical benefits within a couple of days, but optimum benefits occur between 2–6 weeks. Beyond this, the positive effects gradually wane. Average duration of benefits is between 10 and 16 weeks.


Muscle  Botox (units)  Dysport (units)  Xeomin (units)  Myobloc (units)  
Sternocleidomastoid30–50  100–200  30–50  1,000–2,500  
Splenius50–60  200–300  50–60  2,500–5,000  
Semispinalis  30–40  60–150  30–40      750–1,500  
Upper trapezius  40–60  150–200  40–60  1,000–2,500  
Levator scapulae  40–60  150–200  40–60  500–1,000  
Scalene30–50  100–200  30–50  500–1,000  




Side Effects of Botulinum Toxin Therapy

Adverse events associated with BT are often dependent on individual patients, the injector’s expertise, and the total dose administered. About 20–30% of patients reported an occurrence of side effects per treatment cycle.

  1. Dysphagia
  2. Local neck pain
  3. Neck muscle weakness
  4. Dry mouth
  5. Flu-like symptoms

Products Often Used For Cervical Dystonia

The majority of initial trials used botulinum toxin type A injections, while more recent studies have also demonstrated the efficacy of botulinum toxin type B, including those who have developed resistance to BT type A.


Botox is a prescription drug that is approved for treating abnormal head posture and neck pain associated with cervical dystonia. The neurotoxin type A in Botox works by blocking nerve signals that cause muscle spasms. This reduces muscle stiffness and tension.


Dysport is another BT Type A preparation approved for treating cervical dystonia in adults. This prescription medication is injected into muscles to relieve CD symptoms. The safety of Dysport has not been established in CD patients under 18 years of age.


Xeomin is the third type A drug approved for treating cervical dystonia in adults. It works by inhibiting the release of neurotransmitter acetylcholine to temporary decrease muscle activity. This action reduces abnormal head position, neck spasms, and pain in CD patients.


Myobloc (Neurobloc) is the first and only botulinum type B product approved for treating cervical dystonia. It has been found to be effective in adult patients who do or do not respond to type A drugs. In contrast to BT type A products, Myobloc has a rapid onset of action and greater area of diffusion. However, it has a shorter duration of effect and slightly more painful when being injected.

In Short

As a result of overwhelming evidence, botulinum toxin therapy is now widely recognized as a first line of treatment for abnormal posture, muscle hypertrophy, and pain associated with cervical dystonia. In order to obtain optimal result, knowledge of individualized injection patterns, cervical anatomy, and CD classification is useful in better managing the disorder.

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