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Cervical dystonia, also called spasmodic torticollis, is a condition characterized by involuntary muscle contractions in the neck that cause the head to turn to one side or twist. This can be a painful condition and may also result in uncontrollable forward or backward tilting of the head. The muscle contractions occur without the affected person’s conscious control.
While cervical dystonia can affect individuals of any age, it is a relatively uncommon condition. Cervical dystonia typically manifests in middle-aged individuals, with a higher incidence among women than men. In most cases, symptoms develop gradually until they stabilize at a certain point when they don’t significantly worsen.
The condition cervical dystonia cannot be cured. Sometimes the condition goes away on its own, although long-lasting remissions are rare. Botulinum toxin injections into the afflicted muscles frequently alleviate cervical dystonia’s signs and symptoms. In some circumstances, surgery may be necessary.
Symptoms
Cervical dystonia can cause your head to twist in various ways due to the muscle spasms that occur in the affected muscles. This includes the chin toward the shoulder, chin straight up or chin straight down. Another twisting direction is the ear toward the shoulder.
Your chin is dragged toward your shoulder when you experience cervical dystonia, which is the most frequent type of twisting. A combination of aberrant head positions might occur in some people. It’s also possible for the head to jerk.
Neck pain that may spread to the shoulders and headaches are common symptoms of cervical dystonia. For some individuals, the pain associated with cervical dystonia can be exhausting and disabling, with the side of the head that tilts often being the source of the pain.
Causes
Although the exact cause of cervical dystonia is unknown, there is evidence that suggests a genetic component may be involved in some cases as it has been observed to run in families. Cervical dystonia is linked to gene mutations, according to research. Injury to the head, neck, or shoulder has also been associated to cervical dystonia on occasion. In addition to a potential genetic link, other possible causes of cervical dystonia may include neurological disorders like Parkinson’s disease, medication side effects such as those associated with antipsychotics that block dopamine, or a psychological disorder.
Risk factors
Cervical dystonia risk factors include:
- Age. Although the disorder can affect persons of any age, it typically starts after the age of 30.
- Sex. Cervical dystonia is more common in women than in men.
- Family history. You are more likely to acquire cervical dystonia or another type of dystonia if a close relative already has it.
Diagnosis
A physical examination alone may frequently identify cervical dystonia, your doctor may advise blood tests or Magnetic Resonance Imaging (MRI) to rule out any underlying illnesses that could be the cause of your symptoms.
Treatment
Cervical dystonia is a condition that cannot be cured. While spontaneous resolution of symptoms may occur in certain individuals, recurrence of symptoms is common in most cases of this condition. The objective of treatment is to decrease the severity of symptoms.
Medications
Direct injections of the paralyzing substance botulinum toxin, which is frequently used to reduce face wrinkles, can be made into the cervical dystonia-affected neck muscles. Medication made with botulinum toxin include: Myobloc, Xeomin, Dysport, and Botox.
Frequent injections, usually required every three to four months, can often result in improvements for individuals with cervical dystonia.
Your doctor may additionally advise oral drugs that relax muscles in order to enhance outcomes or to assist in reducing the dosage and frequency of botulinum toxin injections.
Therapies
Spasms may momentarily stop if you utilize sensory tricks, such as touching the other side of your face or the back of your head. Various sensory techniques are beneficial for different persons, but they frequently become less effective as the disease worsens.
Your neck and shoulder muscles can be relaxed with the use of heat packs and massage. Activities that increase neck flexibility and strength may be beneficial as well.
Learning stress management skills is crucial because cervical dystonia symptoms tends to get worse when you’re under stress.
Surgery and other procedures
Surgery may be recommended by a doctor if less invasive treatments are unsuccessful. Possible procedures could include:
- Deep brain stimulation. A procedure that involves creating a small hole in the skull to insert a thin wire into the brain. The wire is then directed to the area of the brain responsible for regulating movement. By delivering electrical pulses through the wire, nerve signals that are causing your head to twist can be interrupted, potentially reducing symptoms of cervical dystonia.
- Cutting the nerves. Another choice is to surgically cut the nerves that supply the affected muscles’ contraction signals.
