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Cervical dystonia (CD) affects thousands of people every year.

CD, also called spasmodic torticollis, is a neurological movement disorder that causes the muscles in your neck to contract (tighten) involuntarily.

This muscle tightening can cause you to hold your head and neck in painful, abnormal positions.

These painful, abnormal head positions can cause discomfort and challenges in your everyday life.1

The four most common head positions associated with CD

CD symptoms include:

  • Abnormal and painful turning of head and neck2
  • Increasing neck muscle tightness or spasms2
  • Neck pain3
  • Uncomfortable pulling in the neck2
  • Tremors of the head and neck4
  • Limited range of motion4

Pain is a common complaint of most patients with CD

of patients with CD reported neck pain as a common symptom5
Of those patients, nearly 7 out of 10 said the pain was moderate or severe6
CD pain may interfere with your work and social life1,5,7,8

What causes CD?

Normally, your brain sends chemical signals to your head and neck muscles to keep their movements smooth and controlled. In patients with CD, these signals work improperly. When acetylcholine, one of the chemical signals, is released at above-normal amounts, it causes muscles to be tense and overactive.

In some cases of CD, causes can be linked to neck, head and shoulder injuries, and certain drugs.2

While the exact cause is not clear, research is still being conducted to explore the factors that can contribute to CD.


  1. 1. Camfield L, Ben-Shlomo Y, Warner TT, and the Epidemiological Study of Dystonia in Europe Collaborative Group Impact of cervical dystonia on quality of life. Mov Disord. 2002;17:838–841.
  2. 2. DMRF website:
  3. 3. Costa J, Espirito-Santo C, Borges A, et al. Botulinum toxin type B for cervical dystonia. Cochrane Database Syst Rev. 2005 Jan 25;(1):CD004315.
  4. 4. Jankovic J. Dystonias, choreas, athetosis, and ballism. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. Philadelphia, PA: Saunders; 2004:2312–2314.
  5. 5. Lew MF. Botulinum toxin type B: an effective treatment for alleviating pain associated with cervical dystonia. J Back Musculoskel Rehab. 2002;16:3–9.
  6. 6. Chan J, Brin MF, Fahn S. Idiopathic cervical dystonia: clinical characteristics. Mov Disord. 1991;6:119–126.
  7. 7. Van Zandijcke M. Cervical dystonia (spasmodic torticollis). Some aspects of natural history. Acta Neurol Belg. 1995;95:210–215.
  8. 8. Ben-Shlomo Y, Camfield L, Warner T. What are the determinants of quality of life in people with cervical dystonia? J Neurol Neurosurg Psychiatry. 2002;72:608–614.


MYOBLOC® (rimabotulinumtoxinB) injection is indicated for:

  • the treatment of cervical dystonia (CD) to reduce the severity of abnormal head position and neck pain associated with CD in adults
  • the treatment of chronic sialorrhea in adults


MYOBLOC® may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems anytime (hours to weeks) after treatment with MYOBLOC:

  • Problems swallowing, speaking, or breathing if the muscles that you use to breathe and swallow become weak after the injection. Death can happen as a complication if you have severe problems with swallowing or breathing after treatment with MYOBLOC
  • People with certain breathing problems may need to use muscles in their neck to help them breathe and may be at greater risk for serious breathing problems with MYOBLOC
  • Swallowing problems may last for several months. People who cannot swallow well may need a feeding tube to receive food and water. If swallowing problems are severe, food or liquids may go into your lungs. People who already have swallowing or breathing problems before receiving MYOBLOC have the highest risk of getting these problems
  • Spread of toxin effects. In some cases, the effect of botulinum toxin may affect areas of the body away from the injection site and cause symptoms of a serious condition called botulism. The symptoms of botulism include loss of strength and muscle weakness all over the body, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice (dysphonia), trouble saying words clearly (dysarthria), loss of bladder control, trouble breathing, trouble swallowing (dysphagia)

MYOBLOC is a prescription medicine used in adults that is injected into:

  • Muscles and used to treat the abnormal head position and neck pain that happens with cervical dystonia (CD)
  • Glands that make saliva and is used to treat long-lasting (chronic) drooling (sialorrhea)

Do not receive MYOBLOC if you: are allergic to MYOBLOC or any of its ingredients (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as BOTOX® or BOTOX® Cosmetic, DYSPORT®, or XEOMIN®; have a skin infection at the planned injection site.

Tell your doctor about all your medical conditions, including if you have: a disease that affects your muscles or nerves (such as ALS or Lou Gehrig’s disease, myasthenia gravis, or Lambert-Eaton syndrome); had any side effect from any botulinum toxin product in the past; a breathing problem, such as asthma or emphysema; a history of swallowing problems or aspiration; bleeding problems; drooping eyelids; plans to have surgery; had surgery on your face.

Tell your doctor if you: are pregnant or plan to become pregnant (it is not known if MYOBLOC can harm your unborn baby); are breastfeeding or plan to breastfeed (it is not known if MYOBLOC passes into breast milk).

Tell your doctor about all medicines you take, including: prescription and over-the-counter medicines, vitamins, and herbal supplements. Using MYOBLOC with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received MYOBLOC in the past.

Especially tell your doctor if you: received any other botulinum toxin product in the last 4 months; received injections of botulinum toxin such as BOTOX® or BOTOX® Cosmetic, DYSPORT®, or XEOMIN® in the past (tell your doctor exactly which product you received); recently received an antibiotic injection; take muscle relaxants; take allergy or cold medicines; take sleep medicine.

MYOBLOC can cause serious side effects, including allergic reactions. Symptoms of allergic reaction may include: itching, rash, redness, swelling, wheezing, trouble breathing, or dizziness or feeling faint. Tell your doctor or get medical help right away if you get wheezing, or trouble breathing, or if you get dizzy or faint.

Other side effects of MYOBLOC include:

  • Cervical Dystonia: dry mouth, trouble swallowing, injection site discomfort or pain, headache
  • Sialorrhea: dry mouth, trouble swallowing

For more information, refer to the Medication Guide or talk with your doctor.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.