A double blind placebo controlled crossover trial was performed of botulinum toxin "A" in 20 patients with spasmodic torticollis. There was a statistically significant benefit for those treated with toxin; 12 on toxin improved objectively, compared with four on placebo (p less than 0.04). After a follow up period of one year, 16 still seemed to benefit from repeated toxin injections. The main side effect was dysphagia, which appeared to be dose related in individual patients.
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