Cervical Dystonia

Cervical Dystonia – General Information

Cervical Dystonia (which is also known as Spasmodic – Torticollis) is a syndrome of spasms and involuntary contractions of the muscles (a movement disorder), which are usually painful. The Cervical Dystonia may affect any single part of a patient’s body or more different areas at once. This disease can be inherited or can develop as a result to another disease. The researchers are not very sure about what causes it, but they think that it may be caused by a dysfunction in the part of the brain. This part of the brain is the one responsible of the messages about the muscle contractions which may cause Cervical Dystonia.
The other factors that may lead to the development of this medical disorder may be:

• A genetic defect
• Head or neck injury
• Tumors of the head or neck
• Gastroesophageal reflux in infants – meaning that the acid which exists in the stomach passes into the throat.
• Arthritis of the neck
• Inner ear or eye problems
• Deformities of the bones in the neck
• Deformities of the muscles in the neck
• Infant’s position during pregnancy and delivery
• The damage or malfunction of the nervous system – at the basal ganglia.
• The use of some medications may also lead to the appearance of this disease:
• Phenothiazines
• Butyrophenones

The risk factors of a person to develop this medical disorder include:

• The sex – as this disease is encountered predominant in women
• The age – as this disease usually develops in children who are newborns or under the age of 10, but also in adults who are aged between 30 and 60.
• Family history – the disease is more likely to develop in a person who has relatives who suffer from it.

Cervical Dystonia – Symptoms

It is well known the fact that any medical disorder (including Cervical Dystonia) can trigger a variety of symptoms. Therefore, some of this medical condition's most uncommon symptoms have not been listed (mentioned) here. This is why we strongly recommend you to contact your personal health care provider whenever you develop any unusual, bothersome or unpleasant symptoms. Your personal physician will be able to tell you if you are suffering from Cervical Dystonia or from any other medical disorder. The symptoms usually develop in the childhood, but they can also appear in the late teens or in the early adult adulthood. Here is a list of the most common symptoms that a person who suffers from Cervical Dystonia, may experience:

• Tremors
• Voice problems
• Dragging a foot
• Rotation and tilting of the head to the affected zone
• Stiffness of the neck muscles
• Involuntary contractions of the neck muscles – this leads to abnormal movements
• Enlargement of the neck muscles
• Limited range of motion of the head and also of the neck
• Painful spasms of the neck and upper back muscles
• Jerky head movements
• One shoulder may be elevated and displaced forward
• Muscle hypertrophy
• Neck pain
• Head tremor
• Blepharospasm
• Hand tremor
• Brief, spontaneous remissions
• Oromandibular Dystonia – affects the jaw, tongue and mouth muscles- and leads to speaking and eating problems.
• Writer's cramp dystonia – affects the hands and forearms- which causes painful contractions of the hand’s muscles.
• Cranial dystonia affects the eye jaw, tongue and mouth muscles and is a combination of the Oromandibular Dystonia and Blepharospasm; in addition it has the same symptoms of this disease.
• Laryngeal dystonia – affects the speaking muscles- the affected person may loose he’s voice.

Cervical Dystonia – Treatment

At the moment there is no cure for Cervical Dystonia, but there are a few treatment options which help the patients to control the dystonic symptoms. These treatment options include: oral medicines, injections, surgery, physical therapy and other treatments in order to reduce or if this is not possible, to eliminate the muscle spasms and pains, caused by the Cervical Dystonia. The most common drug therapy is the one named Activa Dystonia Therapy. This therapy uses a technology which stimulates the brain and it is usually used in the chronic cases.
In the rest of the cases the doctors prescribe medicines, which may include:

• Botox – also named botulinum toxin type A, which is the toxin which is produced by the bacteria which causes botulism, which affects the nerves. But if Botox is injected into the muscles, then it leads to a reduction in the muscles’ activity. This drug is used in order to reduce the abnormal head and neck position, and also neck pain in the patients who suffer from Cervical Dystonia. Botox should not be used if the patient is suffering from a neuromuscular disorder (such as: amyotrophic lateral sclerosis, myasthenia gravis etc.) or if he has an infection at the sight of the injection.
• Botulinum Toxin Type A - is a neuromuscular blocking agent
• Botulinum Toxin Type A Parenteral – Local –neuromuscular blocking agent
• Boutlinum Toxin Type B – it used in order to reduce the severity of the abnormal head position and also neck pain in the Cervical Dystonia. This drug is a neurotoxin and it blocks the nerve’s impulses to the muscles, paralyzing the muscle, but only temporarily.
• Botulinum Toxin Type B Parenteral – Local - it used in order to reduce the severity of the abnormal head position and also neck pain. This medicine should not be taken in combination with: aminoglycosides (such as gentamicin), anticholinesterase medicines, neuromuscular blockers as the risk of developing the toxic effects is higher. It also should not be taken along with anticoagulants because this increases the risk of developing a bleeding at the sight of the injection.
• Myobloc - it used in order to reduce the severity of the abnormal head position and also neck pain. This drug is a neurotoxin and it blocks the nerve’s impulses to the muscles, paralyzing the muscle, but only temporarily.
• Myobloc Parenteral – Local - it used in order to reduce the severity of the abnormal head position and also neck pain. This drug is a neurotoxin and it blocks the nerve’s impulses to the muscles, paralyzing the muscle, but only temporarily. It also should not be taken along with anticoagulants because this increases the risk of developing a bleeding at the sight of the injection.

The surgical methods of treating the Cervical Dystonia may include the followings:

• Myectomy – also known as Myotomy is a surgical procedure in which the doctor will remove a part of the overactive muscle. This is a common treatment for blepharospasm, but in some rare cases in which the patient previously followed a drug treatment with botulinum toxin this operation can be performed.
• Ramisectomy – is a surgical procedure, in which the doctor who is performing it cuts the nerve which innervates the overactive muscle.