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If there is a neurologically functional problem such as a twisted neck that becomes painful and the spasm can't be broken with other treatments, than I sould suggest someone with this problem to see a neurologist who could use Botox to relax the problem muscle. It can affect head position and inhibit important movements.
Unfortunately the sternocleidomastoid muscle is one of the critical strap muscles of the neck. Weakening this muscle with BOTOX could make it very difficult to hold up the head. For this reason, treatment of this muscle for cosmetic reasons is not a good idea.
The sternocleidomastoid muscle helps turn the head. The two muscles working together regulate the position of the face - straight or off to the side. Treating it with Botox can potentially cause a decreased function of one muscle, causing a deviation of the head from its central position. I must say I wonder about the sudden number of questions about using Botox to decrease the size of large muscles. And as many questions as there are about this topic, there are many more answers talking about the danger and the inadvisability of performing such a procedure. Using Botox on large muscles would require large quantities of Botox which can potentially be dangerous or even life-threatening. Also, it may induce antibody formation to Botox, and since Botox use is needed every 2-3 months to maintain results, it will be useless with subsequent injections. Please don't do it.
Although Botox could theoretically reduce the size of the sternocleidomastoid muscle, it is not advised, since this muscle is important for head control and movement. You may want to consult with a neurologist to discuss possible reasons for the enlargement of this muscle.
I have noticed an increase recently in people asking about using Botox to shrink normal body muscles because they don't like the look of the muscle. Botox paralyzes muscles, and the muscles of the body are used for structural support, normal movement, and safety (reflexes require normal muscle function to protect you from unexpected injury or danger). Botox is NOT to be used to shrink otherwise normal body muscles. If there is a medical problem with muscle spasm, see a neurologist to get the appropriate amount of MEDICALLY NECESSARY but safe Botox. Do not go to any non-MD providers for muscle issues with Botox. That would be extremely dangerous.