Botulinum toxin injected in small doses directly into muscle binds to the neuromuscular junction and inactivates it for approximately three months. Studies of utility of botulinum toxin are been carried out in writer's cramp (and its variants such as pianist's cramp) in open label and double-blind trials. Treatment appears effective. We have begun a trial of botulinum toxin in spasmodic torticollis with the purpose of analyzing the dysphagia that some of these patients have following injection.