Cervical dystonia (spasmodic torticollis) is a painful condition. The neck muscles contract involuntarily, causing the head to twist or turn to one side. Cervical dystonia can also cause the head to uncontrollably bend forward or backward.
This is a rare disorder that can occur at any age, most often in middle-aged people, women more than men. Symptoms generally begin gradually and then reach a point where they don't get substantially worse.
There is no cure for cervical dystonia. The disorder sometimes resolves without treatment, but sustained remissions are uncommon. Injecting botulinum toxin into the affected muscles often reduces the signs and symptoms of cervical dystonia. In some cases surgery may be appropriate.
Symptoms
The muscle contractions involved in cervical dystonia can cause the head to twist in a variety of directions, including chin toward shoulder, ear toward shoulder, chin straight up and chin straight down.
The most common type of twisting associated with cervical dystonia is when the chin is pulled toward the shoulder. Some people experience a combination of abnormal head postures along with a jerking motion of the head.
Neck pain and headaches that can radiate into the shoulders are also experienced by most people who have cervical dystonia. The pain from cervical dystonia can sometimes be exhausting and obstructive.
Causes
Doctors in most cases do not know why some people develop cervical dystonia and others don't. In some cases, however, head, neck or shoulder injuries appear to be linked to it. Sometimes certain drugs, specific antipsychotic or anti-nausea agents, trigger cervical dystonia.
Risk factors
Risk factors for cervical dystonia include:
- Age. While the disorder can occur in people of any age, even children, it most commonly begins between 40 and 70.
- Sex. Women are more likely to develop cervical dystonia than men.
- Family history. If a close family member has cervical dystonia or some other type of dystonia, the person is at higher risk of developing the disorder.
Complications
Some people who start out with cervical dystonia eventually develop similar symptoms in neighboring regions, such as the shoulder or face. The disability and pain that can be caused by cervical dystonia may result in depression.
Treatment
There is no cure for cervical dystonia. In some people, the symptoms may disappear without treatment, but recurrence is common. Treatment is aimed at relieving the symptoms.
People who have cervical dystonia often use a combination of medications to reduce their symptoms.
The symptoms of cervical dystonia are sometimes eased by additional therapy like:
- Exercises that improve neck strength and flexibility,
- Judicious use of a neck brace,
- Training in stress management techniques.
If less invasive treatments don't help, the doctor may suggest surgery.
Prevention
Currently, there are no medications to prevent cervical dystonia or slow its progression.
