What is cervical dystonia?

Cervical dystonia or spasmodic torticollis is a neurological disorder characterized by the appearance of involuntary muscle contractionss of one or more neck and shoulder muscle groups. These contractions, sometimes painful, can be repetitive and slow movements or abnormal postures that will vary according to the affected muscle group. Symptoms start from gradual way and they usually stabilize in a few months or years. Although there is a small percentage of cases in which it remits spontaneously, and may reappear over the years. This disorder most frequently affects middle aged women (If symptoms appear at an earlier age, it is associated with a worse prognosis).

Types of cervical dystonia

exist 3 types of fairly common dystonias whose movements can be sustained for seconds, jerky or repetitive. They can cause pain and trembling from muscle fatigue. Interestingly the contractions they get worse with stress and tiredness and appear when the person performs a voluntary action:

• Inclination
• Lateralization
• Anteversion or retroversion of the head with elevation or descent of the shoulder.

exist other types of dystonias that can affect a single muscle or several, a part of the body or the whole body. Although some dystonias are of genetic cause, in the vast majority of cases the cause is unknown, although its association with a disorder of origin in the basal ganglia of the brain and related to neurotransmitters is being investigated.

• Blepharospasm : affecting the orbicularis oculi muscle resulting in increased blinking
• Oromandibular dystonia: that affects the orofacial muscles of chewing, tongue and pharynx, leading to an alteration in the process of swallowing and / or speaking.
• Laryngeal dystonia: it affects the laryngeal muscles so it causes alteration in the voice.
• A dystonia non-focal would be hemidystonia (It affects a hemibody and whose appearance forces to rule out a hemiplegia due to a cerebrovascular accident).

How is it diagnosed?

There are no diagnostic tests confirming this entity, the suspicion of suffering from this disorder is based on the Symptoms and signs that the person presents affects. Diagnostic tests are not intended to confirm, but rather to rule out other pathologies that present with similar symptoms and with which a differential diagnosis must be made. The is the most common diagnostic test.

Is there any treatment?

There is no specific treatment that stops the symptoms or slows down their evolution, but there are "treatments" that are aimed at relief of symptoms.

Botulinum Injection or Botox

Currently, it is the main treatment of focal dystoniasAlthough, thanks to the good results obtained, it has also begun to be applied for cervical dystonia. Treatment consists of an injection of Botox into the affected muscle or muscle group that causes a temporary relief of symptoms. The action of botulinum toxin causes a neuromuscular block and, therefore, a muscle weakness that is dose dependent. Clinical improvement is experienced during the first week and persists for 2 to 3 months. After that period, you must, if necessary.

The most common side effects are redness and mild swelling that appear locally and are secondary to the injection. We can also find a complete muscle paralysis or the extension of the effect to other muscle groups, such as local weakness and pain. To minimize these eeffects in neighboring structures can be used, which allows the selective choice of the muscle group to be treated. Family Medicine Specialist