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We followed 205 of 232 patients with medically intractable cervical dystonia for at least 3 months and up to 4 years,during which time they received 1,074 injections in 505 visits.One hundred forty-five of the 205 patients(71%)improved substantially(global rating>/=2;from 0=no response to 4=marked improvement in severity and function)after 1 or more visits.Of the 89 patients who reported pain,68(76%)had almost complete relief of their pain.While most patients noted improvement within the 1st week after injection,some had a latency of up to 8.5 weeks.Duration of maximum benefit lasted up to 12.5 months in some,but the average was 11.2 weeks. Only 58 of 205(28%)patients,seen in 76 of 505 visits(15%of all visits),had complications,primarily mild dysphagia(35 patients)or neck weakness(17 patients).We conclude that botulinum toxin is a safe and effective therapy for most patients with cervical dystonia. |
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