Cervical dystonia, also known as spasmodic torticollis, is a focal dystonia. It is characterized by involuntary neck muscles contractions causing abnormal movements and awkward posture of the head and neck. The movements may be sustained or may cause tremor or jerking of the head. Spasms in the muscles or pinched nerves in the neck can result in considerable pain and discomfort.
Cervical dystonia may be primary or secondary.
Chronic neck pain
The involuntary movements and muscle activation of this dystonia is a poorly recognized cause of long standing neck pain.
It is diagnosed when rheumatological and orthopedic causes of neck pain have been excluded. The neck pain of dystonia is usually accompanied by tremor (which may be subtle) and slight changes in posture.Specific words may be used to describe the position of the neck: laterocollis (head tilts to side); retrocollis (head tilts back), anterocollis (head tilts forward).
Cervical dystonia goes by other names including: spasmodic torticollis, torticollis, adult onset focal dystonia.
Symptoms
In cervical dystonia, the neck muscles contract involuntarily. If the contractions are sustained, they may cause abnormal posture of the head and neck. If the spasms are periodic or patterned, they may produce jerky head movements. The severity of cervical dystonia varies from mild to severe. Movements are often partially relieved by a ‘sensory trick’ (also known as geste antagoniste) such as gently touching the chin, other areas of the face, or back of the head.
Cervical dystonia may begin in the neck and spread into the shoulders, but the symptoms usually plateau and remain stable within five years of onset. This form of focal dystonia is unlikely to spread beyond the neck and shoulders or become generalized dystonia. Occasionally, people with cervical dystonia develop other focal dystonias.
The usual treatment for cervical dystonia is injection of muscle relaxants, which in many cases can substantially improve symptoms.
A number of Neurologists at Neurology Network Melbourne specialise in these injections:
