Treatment Options for Cervical Dystonia

First-Line Treatment: Botulinum Toxin

• Botulinum toxin injections should be offered as the first-line treatment for cervical dystonia, with AboBoNT-A and rimaBoNT-B having the strongest evidence for efficacy 1, 2, 3
• All FDA-approved formulations of botulinum neurotoxin are commonly used to treat cervical dystonia, though with differing levels of evidence 1, 2
• AboBoNT-A (Dysport) and rimaBoNT-B (Myobloc) have similar efficacy and should be offered as first-line options 3, 4
• OnaBoNT-A (Botox) and incoBoNT-A (Xeomin) also have similar efficacy and should be considered as treatment options 1

Adjunctive Treatments

• Referral to rehabilitation specialists for comprehensive neuromusculoskeletal management is recommended 5, 6
• Nerve-stabilizing agents, such as Pregabalin, Gabapentin, and Duloxetine, can be prescribed for pain management and spasm control 5, 6

Special Considerations

• Head and neck cancer survivors with cervical dystonia should be assessed and treated with the same approach 7, 5, 6