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From the Dystonia Clinical Research Center, Neurological Institute, Columbia Presbyterian Medical Center, New York, NY.
We enrolled 55 patients in a double-blind, placebo-controlled, parallel design study of the effectiveness of botulinum toxin (Botox) injections for the treatment of spasmodic torticollis. Patients received a standard series of injections, either placebo or Botox. We determined the sites of injection and dose per muscle by the nature of head deviation. Compared with placebo, Botox produced statistically significant improvement in the severity of torticollis, disability, pain, and degree of head turning. There were no serious side effects. During the double-blind phase, 61% of patients injected with Botox improved; 74% of patients subsequently improved during a later open phase at a higher dose of Botox. Direction of head turning, severity of torticollis, and presence or absence of jerky movements did not significantly influence the response rate. We conclude that Botox is a valuable treatment for spasmodic torticollis.
Address correspondence and reprint requests to Dr. Paul Greene, 710 W. 168th Street, New York, NY 10032.
Supported in part by FDA grant FD-R-000195–01 and the Dystonia Medical Research Foundation. Statistical analysis was performed on the Clinfo computer system of the General Clinical Research Centers which is supported by MM-RR00645–15.
Received May 24, 1989. Accepted for publication in final form January 16, 1990.
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