Cervical Dystonia
What is Dystonia?
Dystonia is the name given to a group of conditions which involve the involuntary twitching, spasm or movement of muscles. These spasms and movements may affect one part of the body - such as the eyes, neck or a limb (focal dystonia), a larger region - such as the neck and the arms (segmental dystonia), many parts of the body (multi-focal dystonia) or the whole body (generalised dystonia).
In most cases the underlying cause of dystonia is not yet known. We do know, however, that dystonia is more common in women than in men and that a family history of head and hand tremors exists in some cases. Most focal dystonias start in adult life between the ages of 35-50. A very small percentage of dystonia cases result from trauma or arises as a side effect of taking some medications.
What is Cervical Dystonia?
Cervical dystonia, also called spasmodic torticollis, affects the neck making it difficult to hold the head up straight. The neck muscles go into spasm, making the head pull, turn, jerk or tilt towards the shoulder. The shoulder may also be elevated towards the tilted head. Muscle spasms which cause the neck to twist to one side are named laterocollis, forwards (anterocollis) or backwards (retrocollis). The abnormal postures caused by these conditions may be associated with distressing pain.
How is Cervical Dystonia treated?
If dystonia is causing great discomfort, then drug treatment may be recommended to try to control the muscle spasms. Most medications have not shown satisfactory effects, however, injections of botulinum toxin (type A) have been shown to be very effective for some patients. Botulinum toxin (type A) acts by stopping specific muscles from moving excessively. Treatment with botulinum toxin (type A) takes effect three to seven days after injection, but many people start to feel better within hours. The effect of each treatment lasts about three to four months.
Surgery is used to treat some types of dystonia, but only in rare cases. Surgery may be used to cut the nerves or the contracting muscles to paralyse them. However, in most cases of dystonia surgery is not an appropriate option.