The incidence and nature of dysphagia following botulinum toxin injections for torticollis

A prospective study of 123 consecutive patients with spasmodic torticollis (ST) receiving botulinum toxin (BTX) investigated the incidence of dysphagia and other side effects by means of questionnaire. Eighty-one (66%) completed questionnaires. Of the 42 patients who did not respond, 38 reported no side effects on follow-up. Four were lost to follow-up. Dysphagia was reported by 12 patients (9.7%) onset averaged 5.4 days postinjection (range: 1 day-2 weeks). Duration averaged 10 days (range: 2 days-3 weeks). Videofluoroscopy conducted on 2 patients with reported severe problems swallowing both solids and liquids demonstrated 2 different forms of dysphagia, 2-weeks and 3-months postinjection. Dysphagia may be present prior to treatment in some cases of spasmodic torticollis (ST). Swallowing competence should be checked before treatment with BTX injections