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Sample text
Symptoms of radiation fibrosis can develop during radiation or years later. More rapidly progressive symptoms may indicate a worse prognosis in some instances but may also suggest a superimposed disorder that is not directly related, such as an acute cervical radiculopathy from a disk herniation that might change the treatment strategy. The specific radiation-induced muscular disorders that are likely to be amenable to BTX injections include focal muscle spasms, such as trismus, cervical dystonia, paraspinal muscle spams, and extremity muscle spasms (40,41).
Clinical evaluation with particular emphasis on the patient’s historical account of symptoms and physical examination are instrumental in choosing targets and dosing for therapy. As with other inductions for BTX injection, technique is often modified on subsequent injection visits to maximize efficacy. The dose, volume, and concentration of BTX injected for radiation-induced cervical dystonia varies widely (Table 2). The most frequently injected muscles are the cervical paraspinal muscles, sternocleidomastoid, and trapezius.
A few common clinical scenarios will be detailed. , Irvine, CA), which is used preferentially in cancer patients because of its efficacy, duration of action, predictable spread within tissues, and minimal systemic absorption. Radiation-induced trigeminal neuralgia is a common complication of radiation to the head and neck for nasopharyngioma and other neoplasms. Extensive surgical resections are often used with radiation and may significantly contribute to damage of one or more branches of the trigeminal nerve.