Cervical Dystonia Refractory to Botulinum Toxin Responding to Radiofrequency Ablation: A Case Report
Saugat Dey, Sayantani Ghosh Benefis Health System, Great Falls, MT, USACorrespondence: Saugat DeyPain Management Center, Dartmouth-Hitchcock Medical Center, 7 Timberwood Drive, Apt 230, Lebanon, NH 03766, USATel +1 267 736 0286Email saugatharidwar@gmail.comAbstract: A 62-year-old male diagnosed with...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-09-01
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| Series: | Journal of Pain Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/cervical-dystonia-refractory-to-botulinum-toxin-responding-to-radiofre-peer-reviewed-article-JPR |
| _version_ | 1818505353374990336 |
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| author | Dey S Ghosh S |
| author_facet | Dey S Ghosh S |
| author_sort | Dey S |
| collection | DOAJ |
| description | Saugat Dey, Sayantani Ghosh Benefis Health System, Great Falls, MT, USACorrespondence: Saugat DeyPain Management Center, Dartmouth-Hitchcock Medical Center, 7 Timberwood Drive, Apt 230, Lebanon, NH 03766, USATel +1 267 736 0286Email saugatharidwar@gmail.comAbstract: A 62-year-old male diagnosed with cervical dystonia (CD) and chronic right-sided neck pain presented to the Pain Clinic after his pain and CD symptoms failed to resolve with botulinum toxin therapy. During clinical examination, right C3-C4 and C4-C5 facet arthropathy was suspected. After two sets of diagnostic right cervical, C3, C4, and C5 medial branch blocks provided > 80% pain relief; cervical radiofrequency ablation (CRFA) was performed. Post CRFA, the patient was followed for 12 months. Till the last follow-up, he was not only experiencing 90% pain relief, but also had significant improvement in his CD symptoms to the point that he no longer needed botulinum toxin and other CD-related therapy. This report suggests that large-scale research is required to postulate whether CD patients, whose symptoms are refractory to botulinum toxin, should be routinely screened for cervical facet arthropathy. This is the first reported case of improvement in CD symptoms with CRFA. This effect could be explained by the fact that certain deep cervical muscles, which are affected in CD, are innervated by medial branch nerves.Keywords: cervical dystonia, radiofrequency ablation, botulinum toxin, neck pain, medial branch nerves, deep neck muscles |
| first_indexed | 2024-12-10T21:49:31Z |
| format | Article |
| id | doaj.art-f7cd26498cf24a90b7f7820117e70632 |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-12-10T21:49:31Z |
| publishDate | 2020-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-f7cd26498cf24a90b7f7820117e706322022-12-22T01:32:15ZengDove Medical PressJournal of Pain Research1178-70902020-09-01Volume 132313231657144Cervical Dystonia Refractory to Botulinum Toxin Responding to Radiofrequency Ablation: A Case ReportDey SGhosh SSaugat Dey, Sayantani Ghosh Benefis Health System, Great Falls, MT, USACorrespondence: Saugat DeyPain Management Center, Dartmouth-Hitchcock Medical Center, 7 Timberwood Drive, Apt 230, Lebanon, NH 03766, USATel +1 267 736 0286Email saugatharidwar@gmail.comAbstract: A 62-year-old male diagnosed with cervical dystonia (CD) and chronic right-sided neck pain presented to the Pain Clinic after his pain and CD symptoms failed to resolve with botulinum toxin therapy. During clinical examination, right C3-C4 and C4-C5 facet arthropathy was suspected. After two sets of diagnostic right cervical, C3, C4, and C5 medial branch blocks provided > 80% pain relief; cervical radiofrequency ablation (CRFA) was performed. Post CRFA, the patient was followed for 12 months. Till the last follow-up, he was not only experiencing 90% pain relief, but also had significant improvement in his CD symptoms to the point that he no longer needed botulinum toxin and other CD-related therapy. This report suggests that large-scale research is required to postulate whether CD patients, whose symptoms are refractory to botulinum toxin, should be routinely screened for cervical facet arthropathy. This is the first reported case of improvement in CD symptoms with CRFA. This effect could be explained by the fact that certain deep cervical muscles, which are affected in CD, are innervated by medial branch nerves.Keywords: cervical dystonia, radiofrequency ablation, botulinum toxin, neck pain, medial branch nerves, deep neck muscleshttps://www.dovepress.com/cervical-dystonia-refractory-to-botulinum-toxin-responding-to-radiofre-peer-reviewed-article-JPRcervical dystoniaradiofrequency ablationbotulinum toxinneck painmedial branch nervesdeep neck muscles |
| spellingShingle | Dey S Ghosh S Cervical Dystonia Refractory to Botulinum Toxin Responding to Radiofrequency Ablation: A Case Report Journal of Pain Research cervical dystonia radiofrequency ablation botulinum toxin neck pain medial branch nerves deep neck muscles |
| title | Cervical Dystonia Refractory to Botulinum Toxin Responding to Radiofrequency Ablation: A Case Report |
| title_full | Cervical Dystonia Refractory to Botulinum Toxin Responding to Radiofrequency Ablation: A Case Report |
| title_fullStr | Cervical Dystonia Refractory to Botulinum Toxin Responding to Radiofrequency Ablation: A Case Report |
| title_full_unstemmed | Cervical Dystonia Refractory to Botulinum Toxin Responding to Radiofrequency Ablation: A Case Report |
| title_short | Cervical Dystonia Refractory to Botulinum Toxin Responding to Radiofrequency Ablation: A Case Report |
| title_sort | cervical dystonia refractory to botulinum toxin responding to radiofrequency ablation a case report |
| topic | cervical dystonia radiofrequency ablation botulinum toxin neck pain medial branch nerves deep neck muscles |
| url | https://www.dovepress.com/cervical-dystonia-refractory-to-botulinum-toxin-responding-to-radiofre-peer-reviewed-article-JPR |
| work_keys_str_mv | AT deys cervicaldystoniarefractorytobotulinumtoxinrespondingtoradiofrequencyablationacasereport AT ghoshs cervicaldystoniarefractorytobotulinumtoxinrespondingtoradiofrequencyablationacasereport |