Botulinum toxin for cervical dystonia: addressing treatment failure and improving outcomes.

Introduction: Cervical dystonia is a form of focal dystonia characterised by tilting and turning of the head and neck. This can cause significant disability in affected patients. Botulinum toxin injections are the mainstay of therapy. However, approximately 30% of patients discontinue treatment.

Clinical Reflections: Tyślerowicz et al. have provided a comprehensive review of the factors contributing to treatment failure. Such factors include appropriate identification of dystonia patterns, accurate injection of muscles, and addressing non-motor features of cervical dystonia.

Clinical Implications: A systematic approach is needed to identify and address the potentially modifiable factors that contribute to treatment failure.