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Head and Neck Muscle Spasm After Radiotherapy
Management With Botulinum Toxin A Injection
Douglas J. Van Daele, MD;
Eileen M. Finnegan, PhD;
Robert L. Rodnitzky, MD;
Weining Zhen, MD;
Timothy M. McCulloch, MD;
Henry T. Hoffman, MD
Arch Otolaryngol Head Neck Surg. 2002;128:956-959.
Objective To introduce the concept of neck muscle pain and spasm after radiotherapy
and its treatment with botulinum toxin A.
Design Case series.
Setting Ambulatory patients at a tertiary care medical center.
Patients Individuals who had undergone primary or adjuvant radiotherapy for treatment
of carcinoma of the head and neck were asked about painful spasms of the neck
musculature. A volunteer sample was used. If they desired treatment with botulinum
toxin A, they were included in the study.
Intervention Patients received botulinum toxin A injections to the affected sternocleidomastoid
muscle(s) in 1 or 2 locations.
Outcome Measure Subjective pain relief.
Results Four of 6 patients with painful tightness of the neck who received botulinum
toxin A injections to the sternocleidomastoid muscle achieved pain relief.
Conclusions A subset of patients with irradiation-induced cervical muscle spasm
benefit from treatment with botulinum toxin A injections. Further study is
needed to more clearly define the entity and treatment.
From the Departments of Otolaryngology–Head and Neck Surgery
(Drs Van Daele, Finnegan, McCulloch, and Hoffman), Neurology (Dr Rodnitzky)
and Radiology, Division of Radiation Oncology (Dr Zhen), University of Iowa
Health Care, Iowa City. Dr Zhen is now with the Departments of Radiation Oncology
and Otolaryngology–Head and Neck Surgery, University of Nebraska Medical
Center, Omaha.
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