Objective: To facilitate the education of physicians new to  botulinum neurotoxin treatment of cervical dystonia.

Background: Cervical dystonia (CD) is a hyperkinetic movement disorder characterized by involuntary contractions of neck muscles that result in abnormal head and neck positioning. Injection of botulinum neurotoxin type A (BoNT-A) into the affected muscles represents the standard treatment for CD. Successful application of BoNT-A requires structured training and experience, which currently lacks standardized educational frameworks in Germany.

Method: To facilitate the education of physicians new to BoNT-A therapy, an expert panel developed a simplified training concept specifically for physicians beginning BoNT-A treatment in CD. It is derived from the established Col-Cap classification and translates its principles into a structured, stepwise approach for clinical practice.

Results: The concept provides consensus-based recommendations covering the key elements of BoNT-A treatment in CD, including recognition of dystonic movement patterns, identification of target muscles, use of ultrasound guidance, determination of injection sites, and dose selection.

Conclusion: By translating complex pathophysiological and anatomical considerations into a practical training structure, Dystonia 3×3 offers an accessible guide that may improve safety, reproducibility, and standardization in the treatment of CD. Future studies are needed to evaluate its clinical effectiveness and to explore whether the structured framework could support automated or artificial intelligence–assisted treatment decision tools.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/dystonia-3x3-a-training-framework-for-beginners-in-botulinum-neurotoxin-treatment-of-cervical-dystonia/