About spasmodic torticollis

What is spasmodic torticollis?

Cervical dystonia, also known as spasmodic torticollis, is a rare neurological disorder characterized by involuntary muscle contractions in the neck that cause abnormal movements and postures of the neck and head. In some cases, these abnormal contractions may be sustained or continuous; in others, they may be present as spasms that can resemble tremor. The severity of cervical dystonia can vary, but the disorder can cause significant pain and discomfort as well as difficulty due to the abnormal postures. Cervical dystonia typically begins in middle age, and rarely begins in adolescence and young adulthood. The cause of cervical dystonia is unknown, although a genetic susceptibility is thought to underlie some cases. If cervical dystonia begins in infancy or early childhood, secondary causes should be investigated.

Cervical dystonia is the most common form of focal dystonia that presents in an office setting. Dystonia is generally characterized by involuntary muscle contractions that force the body into abnormal, sometimes painful, movements and positions (postures). Cervical dystonia is a form of dystonia that involves the neck area. Symptoms may vary among affected individuals, including the age at onset, intensity, presence of pain, and degree of disability.

What are the symptoms for spasmodic torticollis?

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.

Many people who have cervical dystonia also experience neck Pain that can radiate into the shoulders. The disorder can also cause headaches. In some people, the Pain from cervical dystonia can be exhausting and disabling.

What are the causes for spasmodic torticollis?

In most people with cervical dystonia, the cause is unknown. Some people who have cervical dystonia have a family history of the disorder. Researchers have found gene mutations associated with cervical dystonia. Cervical dystonia is also sometimes linked to head, neck or shoulder injuries.

What are the treatments for spasmodic torticollis?

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.

Medications

Botulinum toxin, a paralyzing agent often used to smooth facial wrinkles, can be injected directly into the neck muscles affected by cervical dystonia. Examples of botulinum toxin drugs include Botox, Dysport, Xeomin and Myobloc.

Most people with cervical dystonia see an improvement with these injections, which usually must be repeated every three to four months.

To improve results or to help reduce the dosage and frequency of botulinum toxin injections, your doctor might also suggest oral medications that have a muscle-relaxing effect.

Therapies

Sensory tricks, such as touching the opposite side of your face or the back of your head, may cause spasms to stop temporarily. Different sensory tricks work for different people, but they often lose effectiveness as the disease progresses.

Heat packs and massage can help relax your neck and shoulder muscles. Exercises that improve neck strength and flexibility also may be helpful.

The signs and symptoms of cervical dystonia tend to worsen when you're stressed, so learning stress management techniques also is important.

Surgery and other procedures

If less invasive treatments don't help, your doctor might suggest surgery. Procedures may include:

  • Deep brain stimulation. In this procedure, a thin wire is guided into the brain through a small hole cut into the skull. The tip of the wire is placed in the portion of the brain that controls movement. Electrical pulses are sent through the wire to interrupt the nerve signals making your head twist.
  • Cutting the nerves. Another option is to surgically sever the nerves carrying the contraction signals to the affected muscles.

What are the risk factors for spasmodic torticollis?

Risk factors for cervical dystonia include:

  • Age. While the disorder can occur in people of any age, it most commonly begins after age 30.
  • Your sex. Women are more likely to develop cervical dystonia than are men.
  • Family history. If a close family member has cervical dystonia or some other type of dystonia, you are at higher risk of developing the disorder.

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