Five patients with Idiopathic Spasmodic Torticollis (IST), one associated with Meige's disease, have been cured by local injection of purified botulinum "A" toxin (BT). The therapeutic effect on the different subjects treated proved to be variable, and often the effect varied as well on the same subject from session to session. The response was only partly related to the dose of BT injected, and appeared inversely proportional to the number of hyperactive muscles. Transient dysphagia was the major untoward effect of the treatment. The inconstant response to BT makes us consider BT worth to be used selectively in the so-called "agonistic" cases of IST.
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