Cervical dystonia, also called spasmodic torticollis, is a painful condition in which your neck muscles contract involuntarily, causing your head to twist or turn to one side. Cervical dystonia can also cause your head to uncontrollably tilt forward or backward.
A rare disorder that can occur at any age, even infancy, cervical dystonia most often occurs in middle-aged people, women more than men. Symptoms generally begin gradually and then reach a point where they don't get substantially worse.
There is no cure for cervical dystonia. The disorder sometimes resolves without treatment, but sustained remissions are uncommon. Injecting botulinum toxin into the affected muscles often reduces the signs and symptoms of cervical dystonia. Surgery may be appropriate in a few cases.
The muscle contractions involved in cervical dystonia can cause your head to twist in a variety of directions, including:
The most common type of twisting associated with cervical dystonia is when your chin is pulled toward your shoulder. Some people experience a combination of abnormal head postures. A jerking motion of the head also may occur.
Most people who have cervical dystonia also experience neck pain that can radiate into the shoulders. The disorder also can cause headaches. In some people, the pain from cervical dystonia can be exhausting and disabling.
In most cases of cervical dystonia, doctors don't know why some people develop the disorder and others don't. Some cases, however, appear to be linked to:
Risk factors for cervical dystonia include:
Some people who start out with cervical dystonia eventually develop similar symptoms in neighboring regions, such as the shoulder or face. However, cervical dystonia in middle age does not expand to wide areas of the body, as may occur in children.
The disability and pain that can be caused by cervical dystonia may result in depression.
Preparing for your appointment
While you might first discuss your symptoms with your family doctor, he or she may refer you to a neurologist — a doctor who specializes in disorders of the brain and nervous system — for further evaluation.
What you can do
What to expect from your doctor
Tests and diagnosis
While the physical examination alone can often confirm a diagnosis of cervical dystonia, it's important to determine if there are underlying conditions causing your signs and symptoms. Tests may include:
Treatments and drugs
There is no cure for cervical dystonia. In some people, signs and symptoms may disappear without treatment, but recurrence is common. Treatment focuses on relieving the signs and symptoms.
Surgical and other procedures
Lifestyle and home remedies
Cervical dystonia has no cure, but you can do a number of things to minimize its effects:
Some types of alternative medicine techniques may help the medications prescribed to treat cervical dystonia work better or for longer periods of time. For example, massage or other strategies that tend to relieve muscle tension may be tried.
Coping and support
Severe cases of cervical dystonia may make you feel uncomfortable in social situations or even limit your abilities to accomplish everyday tasks such as driving. Many people with cervical dystonia feel isolated and depressed.
Remember that you're not alone. A number of organizations and support groups are dedicated to providing information and support for you and your family — whether you have the disorder or you have a friend or family member who does.
Your doctor may be able to suggest support groups available in your area, or there are a number of good sites on the Internet with information about local support groups.
Last Updated: 2011-01-08
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