Cervical dystonia is a condition that falls under the larger category of focal dystonia, all of which serve a single characteristic of affecting a single place of the body. Cervical dystonia manifests itself through involuntary movements of muscles around the neck, sometimes including the shoulders as well.
This in turn leads to substantial degrees of pain and discomfort, leading to slight movements of the head or changing the postures of head to lead to awkward positions. In many of the cases, this form of dystonia rarely spreads to other areas of the body, instead focusing at the neck for several weeks, months or even years.
Although this form of dystonia can lead to discomfort and pain, it rarely deteriorates to severe forms over the long term, in turn plateauing over time and patients do find tricks to beat the condition over time. Other names that may be used interchangeably with this condition include:
- Spasmodic torticollis
- Adult onset focal dystonia
Who is affected?
Cervical dystonia affects individuals of all walks of life. It affects both men and women across all ages, though it is more prevalent in ages between thirty to sixty years, although it may strike at earlier ages as well. However, this condition is more prevalent in women than it is in men, and in some cases, a certain underlying factor of genetic inheritance may have an effect on chances of it befalling on an individual.
What are the causes?
The specific cause of cervical dystonia remains unknown. However, many experts do argue that it may be a result of wrong communication from the brain to the neck and surrounding muscles. A genetic factor is also evident in some of the cases, where chances of this condition unfolding at younger ages are heavily dependent on previous family history. There are two major classes of this condition as well, which link to the causes of the condition. This includes:
- Primary cervical dystonia, which results from apparent neurological malfunction with or without a family history to that effect
- Secondary cervical dystonia results from physical trauma such as falling, accidents etc. This may also have a genetic factor
Types of cervical dystonia
Cervical dystonia has four major subclasses. This depends on the kind of pain and movements that the patient experiences when suffering from this condition. A patient may experience sustained movements, which lead to a change in posture of the neck and head or experience constant slight movements that make the head unstable and in constant motion. The most common forms of cervical include:
- Torticollis, which involves the head tilting forward and sideways
- Laterocollis, which involves the head tilting sideways while maintaining the usual vertical height
- Anterocollis, where the head tilts towards the front
- Retrocollis, where the head tilts to the back
Symptoms of cervical dystonia
The symptoms of cervical dystonia are similar to several other kinds of focal dystonia, which unfold with localized pains around certain regions. The common symptoms of this form of dystonia include:
- Uncontrollable muscle movements around the neck, leading to constant movements or altering head posture
- Pain around the neck and neck muscles
- Head tilting
- Tremors and other neurological disorders
- Other forms of focal dystonia may point to the possibility of cervical dystonia as well
Diagnosis of cervical dystonia
To this date, there is no solid test for ascertaining the presence of cervical dystonia. The diagnosis of this form of dystonia heavily relies on a combination of physical and neurological examinations along with the information from the patient. A neurologist usually examines the state of the neck and seeks information from the patient to draw a conclusion on the presence of this condition.
Several other conditions espouse similar conditions to cervical dystonia, which highlights the need to seek for specialized advice rather than taking up alternatives at the go. Some of the common disorders that may have similar symptoms include:
- Local orthopedic
- Ophthalmologic conditions
- Stiff neck
Treatment of cervical disorder
There is no single known treatment of cervical dystonia. However, several techniques are known to alleviate the pain and slow down most symptoms to allow the affected individuals regain their normal lives. Although this condition may affect the individual for a long time, in some cases the symptoms do while away, but the risk of reoccurring is always high. Certain forms of medications have been devised with varying degrees of success among patients.
Botulin toxin is one of the most effective treatments for this condition. Regular injection of this drug to the contracting muscles helps to cool down the pain, correct the involuntary contractions and help the patient to regain control over their muscle movements.
A number of oral medications are now available, although with varying degrees of success in different patients. Taking these drugs from time to time or at peak times of the pain helps to slow down the pain and introduce a relative level of comfort to the victim.
Selective denervation surgery is another worthwhile option in the case of severe attacks. Done by neurologists, this helps to correct the malfunctioning nerves and alleviate the pain in the victim.
Physical therapy that involves gentle massage of the affected regions by a qualified therapist helps in introducing a soothing feeling to the affected parts to help regain comfort. The therapist rubs on the painful muscles in regular patterns to help them relax and col down the pain. Over time, this may form part of the relaxation techniques in some patients. However, this form of treatment is quite demanding both for the therapist and for the patient.
Psychological therapy has shown effective results in some of the cases, especially severe ones. Although cervical dystonia does not affect the brain, it may lead to stress, anxiety or even depression because of immense pain, stigma and trauma that accompanies it. The social isolation that it may bring upon the patient is also likely to contribute to this condition, which calls in the intervention of psychotherapy techniques. These are helpful in allowing the patient to manage pain and find new ways to cope.