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Cervical Dystonia

What is Cervical Dystonia?

Cervical dystonia or neck dystonia is a chronic neurological disorder characterized by involuntary contractions of the neck muscles, causing abnormal postures, tremors, and muscular spasms. These symptoms can be painful and debilitating, interfering with a patient’s daily activities.

While essentially a rare disease, cervical dystonia is the third most common movement disorder, following Parkinson’s disease and essential tremor. You may also encounter the term spasmodic torticollis, which is another name for cervical dystonia.

The estimated global prevalence of cervical dystonia ranges from 5.7 to 400 per 100,000 people, with women being more commonly affected than men. Although it can develop at any age, it typically affects individuals between the ages of 40 and 50.

Symptoms of cervical dystonia may include:

  • Neck pain that radiates to the shoulders
  • Raised shoulder
  • Head tremors
  • Headache
  • Hand tremor
  • Difficulty turning the head
  • Fatigue
  • Depression and anxiety

Scientists believe that dystonia stems from faulty signals in the nervous system, which result in involuntary muscle contractions. However, the neurological mechanisms responsible for this abnormal muscle activity remain largely unclear.

Dystonia can manifest in two forms: primary or secondary. Primary dystonia, also known as isolated dystonia, lacks any identifiable cause. Isolated cervical dystonia, which typically affects adults, may be genetically inherited.

In contrast, secondary dystonias arise due to specific structural or metabolic causes and are often accompanied by other neurological symptoms. Physical trauma and drug reactions are also causes of acquired cervical dystonia.

Botulinum toxin is the preferred treatment for most individuals suffering from cervical dystonia. This method involves injecting the toxin into the overactive neck muscles that cause abnormal posture or tremors. Reducing these muscles’ overactivity, involuntary muscle contractions that cause pain, twisting and turning of the neck.

Before administering the injections, your neurologist may use electromyography (EMG) to record your muscle activity. The use of ultrasound and EMG considerably decreases the likelihood of side effects during this treatment. Controlled studies have demonstrated that botulinum toxin injections are a safe and effective treatment for cervical dystonia for over 20 years.

Ideal candidates for botulinum toxin treatment are those who have recurrent involuntary contraction of one or more neck muscles, head tremors, neck pain and abnormal head posture.

Patients who prefer not to take regular medications or have medication side effects.

The use of botulinum toxin (Botox, Dysport, and Xeomin) is subsidized by PBS for patients with cervical dystonia, either as a standalone treatment or as a supplementary therapy to standard care.

What to Expect After Treatment?

After receiving botulinum toxin treatment, patients with cervical dystonia can anticipate a decrease in the intensity and frequency of their muscle spasms, resulting in enhanced neck mobility and decreased pain.

Typically, the benefits of botulinum toxin persist for 3 to 4 months, after which additional injections may be necessary. This treatment does not provide a permanent solution for cervical dystonia, but instead serves as a means of symptom management.

Additionally, patients may encounter certain side effects, such as muscle weakness or difficulty swallowing (dysphagia), which should be immediately reported to their movement disorders neurologist.

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If you’re struggling with cervical dystonia, you know how distressing it can be. The constant pain and muscle contractions can make even the simplest tasks seem impossible. Among various therapies, including medications and surgery, botulinum toxin injection is the treatment of choice for cervical dystonia. Contact us today to schedule your appointment and take the first step towards a brighter future.