Endoscopic Injection of the Longus Capiti Muscle in the Treatment of Dystonic Head Flexion

Hicklin, Lucy A.; Marion, Marie-Hélène

doi:10.1002/mdc3.12916

Cited by 5 publications

(2 citation statements)

References 7 publications

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“…Traditional scales for the quantitative evaluation of cervical dystonia are not considered helpful in the assessment of patients with predominant anterocollis [17].…”

Section: Effectiveness and Its Measurementioning

confidence: 99%

A methodological approach for botulinum neurotoxin injections to the longus colli muscle in dystonic anterocollis: A case series of 4 patients and a literature review

Seliverstov

Arestov

Klyushnikov

et al. 2020

Journal of Clinical Neuroscience

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We review the current approaches and their feasibility to treat dystonic anterocollis by injecting longus colli muscle (LCo) with botulinum neurotoxin (BoNT) as well as present our personal experiences in this field compared with the findings from previously published studies. First, we searched the PubMed database for the publications reporting patients who received LCo injections for anterocollis; we also thoroughly examined the references included in each of the found publications. Second, we present and analyze our own experiences in injecting LCo under EMG guidance in patients with dystonic anterocollis due to heredodegenerative disorders. We found 11 publications describing administration of LCo injections for the treatment of dystonic anterocollis in a total of 28 patients with primary dystonia aged between 21 and 80 years. The mean age of our patients was 44.8 years with the mean anterocollis duration being 15 months. OnabotulinumtoxinA in a dose of up to 35 U per LCo muscle was not associated with the development of transient dysphagia. The mean percentage of patient satisfaction was 36.3%, and the mean duration of the beneficial effect was 2.5 months. All patients agreed to receive a repeat injection. We provide a set of empirically based suggestions on the current use of BoNT injections to LCo for managing anterocollis in outpatient clinics, including pretreatment work-up, injection technique, and dose range.

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“…Traditional scales for the quantitative evaluation of cervical dystonia are not considered helpful in the assessment of patients with predominant anterocollis [17].…”

Section: Effectiveness and Its Measurementioning

confidence: 99%

A methodological approach for botulinum neurotoxin injections to the longus colli muscle in dystonic anterocollis: A case series of 4 patients and a literature review

Seliverstov

Arestov

Klyushnikov

et al. 2020

Journal of Clinical Neuroscience

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“…Anterocollis is one of the most challenging dystonic postures to correct and is a common reason for treatment failure [1,2,3]. One of the main difficulties in the treatment is the injection of the deep flexor muscles of the neck such as longus colli (LCo) and longus capiti (LCa) [1,2,4,5]. The injection of the LCo has been regarded as difficult and potentially dangerous [6] and so it is not routinely offered in the clinical setting.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Study to Validate the Anterior Cervical Approach to the Longus Colli Muscle Using Electromyography Control Alone

Hicklin

Koçer²,

Watson

et al. 2020

Tremor and Other Hyperkinetic Movements

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Background: One of the main difficulties in the treatment of dystonic anterocollis is the injection of the deep flexor muscles of the neck such as Longus Colli (LCo). The injection of the LCo has been regarded as difficult and potentially dangerous; since we published our anterior median approach, a number of questions about the precision and the safety of our technique have been raised by colleagues. Methods: 7 patients with anterocollis were injected, using our injection technique and when the needle was deemed to be in place, we used the ultrasound probe to determine what the needle had passed through, the depth of the tip of the needle and if the identified muscle was indeed LCo. Results: On the ultrasound section the LCo muscle is between 24 and 28 mm deep in the patients examined in this study. The location of the needle was confirmed by ultrasound and in most cases the needle was placed in the right axis but sometimes not deep enough. The EMG control made it possible to correct the depth in all cases. In most of the injections the needle traversed the thyroid. No acute incident occurred by this route of injection. Injections were performed between 22 and 28 mm deep. Discussion: From this study and based on a review of complications over 9 years experience with injecting LCo under EMG control using an anterior approach, we conclude that this technique is precise, safe and well tolerated. Summary (Highlights): The injection of the Longus Coli muscle for anterocollis has been regarded as difficult and potentially dangerous. This study showed, using ultrasound to determine the needle trajectory, that the anterior approach using EMG control is a precise, safe and well tolerated technique.

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Botulinum toxin treatment of dystonic anterocollis: What to inject

Marion¹,

Hicklin

2021

Parkinsonism & Related Disorders

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Endoscopic Injection of the Longus Capiti Muscle in the Treatment of Dystonic Head Flexion

Cited by 5 publications

References 7 publications

A methodological approach for botulinum neurotoxin injections to the longus colli muscle in dystonic anterocollis: A case series of 4 patients and a literature review

A methodological approach for botulinum neurotoxin injections to the longus colli muscle in dystonic anterocollis: A case series of 4 patients and a literature review

Ultrasound Study to Validate the Anterior Cervical Approach to the Longus Colli Muscle Using Electromyography Control Alone

Botulinum toxin treatment of dystonic anterocollis: What to inject

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