Table 4.

Side effects and contraindications of BoNT treatment for CD.

What is the most effective to avoid dysphagia?	The additional use of ultrasound may lessen recurrent dysphagia	U
What is the most effective strategy in case of neck muscles paresis?	The use of a soft collar can relieve the symptoms of neck extensor muscles paresis	U
What is the most effective strategy to prevent injection pain?	Skin cooling or local application of anesthetic cream reduce injection pain	U
Is BoNT treatment safe during pregnancy and lactation?	BoNT treatment during pregnancy and lactation is not recommended and should be avoided whenever possible	U
Is BoNT treatment safe for CD patients who use anticoagulants?	The risk of hematoma following BoNT treatment by concomitant use of coumarin derivatives is low	U
Is BoNT treatment safe for CD patients with concomitant neurological comorbidities?	Patients with concomitant impairment of neuromuscular transmission may experience clinical deterioration after BoNT treatment, although in selected cases treatment might be safe and beneficial	U

BoNT, botulinum neurotoxin; CD, cervical dystonia.