Definition:
Cervical dystonia pertains to a painful condition characterized by involuntary contraction of neck muscles, which cause the head to twist or turn to one side. Cervical dystonia is also referred to as torticollis or spasmodic torticollis.
Diagnosis:
Cervical dystonia may be diagnosed based on clinical assessment of physical symptoms, usually by a neurologist. The patient's medical history and family history will also be taken into account. A definitive diagnosis can be obtained from: blood tests, urine tests, magnetic resonance imaging (MRI) scans, genetic testing, and electromyography (EMG).
Treatment:
Cervical dystonia may be treated with a combination of oral medications, toxin injections, and surgery. Medications typically involve drugs that reduce acetylcholine levels, regulate GABA neurotransmitters, as well as increase or decrease dopamine levels in the body. In some cases, anticonvulsants may also be prescribed. Botulinum toxin injections may also be done to stop muscle spasms. Surgery is often the last option for treatment, and may include selective denervation surgery and deep brain stimulation.
Symptoms and Signs:
Painful and uncontrollable neck spasms are major signs of cervical dystonia. The condition also causes abnormal neck postures in different directions: the head may tilt forward (anterocollis), backward (retrocollis), or to one side (laterocollis). Additional symptoms include: tremors; headaches; neck pain; enlarged neck muscles; abnormalities in the shape of an infant's head after sleeping on the affected side; shoulder elevation on the affected side; and restricted range of motion.
Causes:
Although the exact cause of cervical dystonia is not understood, the condition is believed to develop as a consequence of excessive or abnormal brain input to muscles; particularly by anomalies in the electrical activity of neurons in the basal ganglia or in the cerebral cortex or both.
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