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Cervical Dystonia

What is cervical dystonia?

Cervical dystonia, also known as spasmodic torticollis, is a form of dystonia. Dystonia is a rare chronic movement disorder characterized by involuntary muscle contractions. There are different forms of dystonia; cervical dystonia is a focal dystonia, which means that one localized body part is affected. In cervical dystonia, contractions in the neck muscles pull the head forward and backward involuntary. It causes awkward posture in the head and neck and can also affect the shoulders. The movements that occur can either be sustained (continuous) or intermittent. Cervical dystonia affects women about twice as often as men. It can occur at any age, but most affected first experience symptoms during middle age. The symptoms usually begin slowly and can plateau over a few months or years.

What are the symptoms of cervical dystonia?

The severity of symptoms can vary. They include the following:
  • Abnormal neck and head movements
  • Abnormal neck and head postures, such as:
    • Chin twisting toward a shoulder, which rotates the head sideways
    • Ear twisting toward a shoulder
    • Head tilting forward
    • Head tilting backward
    • Head tilting toward one side
    • Head shifting on the shoulders in a forward or backward direction
  • Intense neck pain and discomfort
  • Headaches
  • Hand tremors

What causes cervical dystonia?

Cervical dystonia can be primary or secondary. When it is primary, it occurs spontaneously on its own, not due to any other underlying cause. When it’s secondary, the dystonia has been caused by something else. The exact cause of primary cervical dystonia is unknown, though some researchers believe it may be influenced by genetic and environmental factors. Secondary cervical dystonia can be caused by: degenerative brain diseases, toxins, use of certain drugs (particularly anti-psychotics and nausea medications with dopamine receptor blocking activity), and possibly trauma to the neck. Usually, secondary cervical dystonia will be accompanied with symptoms that come from the underlying cause triggering the dystonia.

How is cervical dystonia diagnosed?

Cervical dystonia is diagnosed using the following procedures:
  • Thorough physical exam
  • Recording of patient history
  • Knowledge of the disorder
  • Blood tests and/or MRIs to rule out other possible disorders

What are the treatments for cervical dystonia?

Cervical dystonia treatment typically tries to relieve pain and spasms. It is highly individualized, depending on each patient’s case. Treatment options include, but are not limited to, the following:
  • Botulinum toxin injections (neurotoxin that helps prevent the muscles from contracting)
  • Oral medications
  • Surgery
  • Physical therapy
  • In the case of secondary cervical dystonia, treatment for the illness causing the dystonia
  • Stress management
Sensory tricks (such as touching the opposite side of your face or the back of your head) may also help temporarily stop spasms. While a small percentage of patients experience a spontaneous recovery (remission), it is often temporary, lasting from days to years before symptoms return.

Where can I find out more about cervical dystonia?

Cervical Dystonia Articles