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Cervical Dystonia: Types, Symptoms, Causes, and Treatment
Written by Medicover Team and Medically Reviewed by Dr Krishna Haskar Dhanyamraju , Neurologist
Cervical dystonia, also called spasmodic torticollis, is a neurological condition that causes the neck muscles to contract without control. This can make your head twist, tilt, or turn in uncomfortable ways. While the condition can be painful and affect daily life, understanding its symptoms, causes, and treatment options can help in managing it effectively.
What is Cervical Dystonia?
Cervical dystonia is a type of focal dystonia, meaning it affects a specific part of the body, in this case, the neck. These muscle spasms can cause jerky head movements, poor posture, and discomfort. It most commonly affects middle-aged adults and is more common in women than men.
Some people may notice that gently touching their chin or the back of their head may temporarily improve their head position, this is known as a "sensory trick."
What Are the Different Types of Cervical Dystonia?
Cervical dystonia can appear in different forms depending on the direction and pattern of head and neck movement. These types are classified based on which muscles are affected and how the head is positioned. Identifying the specific type is important for accurate diagnosis and effective treatment.
The condition can be classified based on the direction in which the head moves:
- Torticollis: The head turns to one side (most common type).
- Laterocollis: Head tilts sideways.
- Anterocollis: The head tilts forward.
- Retrocollis: Head tilts backward.
Doctors also classify cervical dystonia as:
- Primary: No clear cause.
- Secondary: Caused by another condition or injury.
What are the Cervical Dystonia Symptoms and Signs?
Recognizing the early signs of cervical dystonia is key to getting a timely diagnosis and treatment. Symptoms often begin gradually and may include mild neck discomfort, abnormal head posture, or involuntary muscle spasms. Early detection can help manage the condition more effectively.
Common Symptoms include:
- Involuntary Muscle Contractions: These are the hallmark of cervical dystonia, causing the head to twist or tilt.
- Abnormal Postures: The head may turn to one side (torticollis), tilt forward (anterocollis), backward (retrocollis), or sideways (laterocollis).
- Neck Pain: Chronic pain is a common symptom due to the constant muscle contractions.
- Tremors: Some individuals may experience head tremors(shaking of the head).
- Limited Range of Motion: The ability to move the head freely can be significantly restricted.
Symptoms may get worse with stress, fatigue, or activity, and may improve with rest.
Cervical Dystonia Causes
The exact cause of cervical dystonia is still unknown. However, several factors may contribute to its development, including genetic influences, nerve signal disruptions, or underlying medical conditions. Understanding these possible causes can help guide diagnosis and management.
- Genetics: A family history of dystonia can increase the risk.
- Injury: Trauma to the head, neck, or shoulders may trigger the onset of symptoms.
- Brain function issues: Problems with the basal ganglia (the part of the brain controlling movement).
- Medications: Certain medications can cause dystonia as a side effect.
- Other Medical Conditions: Conditions such as Parkinson's disease and Huntington's disease are associated with dystonia.
Risk Factors of Cervical Dystonia
You may be at a higher risk of developing cervical dystonia if:
- They are between the ages of 30-60.
- They are female.
- Have a family history of dystonia.
- Have had a brain injury or take certain psychiatric medications.
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Get Second OpinionDiagnosis of Cervical Dystonia
Diagnosing cervical dystonia involves a physical exam, medical history, and sometimes imaging tests. Since symptoms can be similar to other conditions, a thorough evaluation by a neurologist is important to confirm the diagnosis and rule out other causes.
Doctors may also use the following methods:
- Medical History: Discussing symptoms and any family history.
- Clinical Evaluation: A neurologist will assess the patient's symptoms, including the pattern and frequency of muscle contractions and any associated pain.
- Neurological Examination: To assess muscle contractions and abnormal postures.
- Imaging Tests: MRI and CT Scans can help rule out other conditions that may mimic cervical dystonia, such as tumors or structural abnormalities.
- Electromyography (EMG): This test measures electrical activity in the muscles and can help confirm the diagnosis by identifying abnormal muscle contractions.
- Genetic Testing: In cases where a hereditary form of dystonia is suspected, genetic testing may be recommended.
- Blood Tests: To check for underlying medical issues.
The ICD-10 code for cervical dystonia is G24.3, which helps healthcare providers classify and manage the condition.
Cervical Dystonia Treatment Options
There are several treatment options available for managing cervical dystonia. The choice of treatment depends on the severity of symptoms, the patient's overall health, and how well they respond to different therapies. Treatment aims to reduce muscle spasms, improve neck movement, and enhance quality of life.
Medications
Medications can help reduce muscle spasms and pain. Commonly prescribed drugs include:
- Botulinum toxin injections (Botox): The most common and effective treatment. It relaxes specific muscles and lasts 2-3 months.
- Anticholinergics (e.g., trihexyphenidyl): Reduce muscle stiffness.
- Muscle relaxants (e.g., baclofen): Alleviate muscle stiffness.
- Sedatives or anti-anxiety meds (e.g., clonazepam).
Possible side effects: dry mouth, drowsiness, memory issues, or swallowing problems (rare with Botox).
Physical Therapy and Exercises
Physical therapy can help improve muscle strength and flexibility. Specific cervical dystonia exercises may include:
- Stretching exercises: Loosen tight neck muscles.
- Strengthening routines: Support surrounding muscles.
- Posture training: Helps correct head alignment.
- Heat therapy or massage: Reduces tension and discomfort.
Surgical Options
In severe cases, surgery may be considered. Surgical options include:
- Selective Denervation Surgery: Cutting nerves responsible for the spasms.
- Deep Brain Stimulation (DBS): A device implanted in the brain sends electrical signals to control muscle contractions.
When to See a Doctor?
It is important to seek medical advice promptly if you experience symptoms that may indicate a neurological or muscular condition affecting your neck. Early diagnosis and intervention can help manage symptoms more effectively, prevent complications, and improve your overall quality of life. If you notice any unusual or persistent changes related to your neck movements or sensations, consulting a healthcare professional is strongly recommended.
You should consult a doctor if you:
- Notice involuntary neck movements, spasms, or pain.
- Have a family history of dystonia.
- Experience worsening symptoms or side effects from treatment.
- Have difficulty swallowing, speaking, or moving your neck.
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Preventive Measures for Cervical Dystonia
While cervical dystonia cannot always be prevented, certain measures may help reduce the risk or lessen symptom severity. Maintaining good posture, managing stress, and avoiding neck strain are important steps in supporting neck health.
- Stress Management: Techniques such as meditation and deep breathing can help reduce stress, which may trigger symptoms.
- Regular Exercise: Engaging in regular physical activity can improve overall muscle health.
- Ergonomic Adjustments: A supportive pillow, adjustable desk, or proper chair can reduce strain.
- Use of neck braces or collars: May provide short-term relief during flare-ups.
Complications of Cervical Dystonia
If left untreated, cervical dystonia can lead to:
- Chronic pain in the neck and shoulders.
- Fatigue, due to constant muscle tension.
- Difficulty with daily tasks like driving, reading, or sleeping.
- In some cases, the spasms can spread to other parts of the body (face, jaw, arms).
- Long-term, it may lead to bone or nerve changes in the spine, causing numbness or weakness.
Our Experience Treating Cervical Dystonia
At Medicover, we understand how challenging cervical dystonia can be, and we're here to support you every step of the way. Our dedicated team combines advanced diagnostic tools with personalized treatment plans designed to reduce symptoms and improve your quality of life. We focus not just on managing the condition but on providing compassionate care that addresses your unique needs, helping you regain comfort and confidence in your daily movements.
