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Cervical Dystonia

Cervical dystonia, also known as spasmodic torticollis, is one of the most common adult-onset focal dystonias.

A dystonia is an excessive involuntary sustained contraction of muscles causing abnormal posture or repetitive movements. In a patient with cervical dystonia, neck posturing, neck tremor, or neck pain are present and can lead to significant disability if untreated. This medical condition is often underrecognized and misdiagnosed.

Cervical dystonia is an uncommon neurological disorder, affecting approximately 0.01% of the population. It is twice as common in women as in men. It usually begins in middle-aged people with symptoms gradually progressing then usually plateauing two years after symptom onset. The underlying cause of cervical dystonia is unknown. However, when it appears in younger people it may be due to a known genetic disease.

There is no cure for cervical dystonia but treatment options are available. The treatment of choice for cervical dystonia is botulinum toxin injections, which are administered into target neck muscles to cause selective denervation and relaxation of abnormal neck posture. Botulinum toxin injections are the most effective and well-tolerated of treatment options. In expert hands, injections provide excellent symptoms relief with minimal, if any side effects. Botulinum toxin is repeated on a quarterly basis for sustained benefit and covered by most commercial insurance and Medicare plans. Oral medications such as muscle relaxants, benzodiazepines, and anticholinergics can also prescribed as adjunct treatment to botulinum toxin. In refractory cases, surgical therapy with deep brain stimulation is available.

The Mayo Clinic, The National Institutes of Health, UptoDate.com