Cervical dystonia (CD) is a condition that typically presents with cervical
muscle spasm, producing head tilt and cervical rotation. CD is most often
idiopathic, however, in a small number of patients, CD occurs within one day
to one year after mild to severe trauma. This type of CD is further classified as
posttraumatic CD. OnabotulinumtoxinA (Botox) injections are considered to
be a controversial treatment for posttraumatic CD and have produced variable
result. This report describes the case of a 32-year-old female presenting
with a two year history of posttraumatic CD and associated head, neck, and
shoulder pain after obtaining a severe head injury during a motorcycle accident.
OnabotulinumtoxinA was used to successfully treat her posttraumatic
CD muscle spasms and associated chronic pain. Three months after her first
and second ONA treatments, the patient reported at least 50% improvement
in her overall pain symptoms and a noticeable reduction in cervical paraspinal
muscle spasms.
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