Dystonia is classified as a movement disorder. It causes a person's muscles to contract uncontrollably, leading to repetitive movements. It can impact a single muscle, a muscle group, or muscles throughout the entire body.
Cervical dystonia, also known as spasmodic torticollis, is the most common form, affecting about 1% of the population, mostly middle-aged women and men. This painful condition affects the neck muscles and causes the head to twist or turn to one side or to tilt forward or backward. The most common form is when the chin twists toward one of the shoulders. Symptoms usually start gradually, build up, then reach a plateau, where they don’t become substantially worse. At this time, there’s no cure.
At Memphis Neurology, our expert team of neurologists is dedicated to educating patients about their conditions. We also offer personalized treatment plans that combine holistic and integrative approaches, including for cervical dystonia. Here’s what you need to know about the disorder, including what’s likely to trigger it.
In most cases, cervical dystonia is idiopathic — that means there’s no identifiable cause. However, researchers believe it may be in some way related to a problem in the basal ganglia, the area of the brain that initiates muscle contractions. The fault may lie in the way the nerve cells communicate — or fail to communicate appropriately.
Dystonia may be acquired, when basal ganglia damage occurs due to events such as:
Dystonia may also be congenital, with its origin genetic. In some 10-25% of cases, there’s evidence of a family history. However, the symptoms among affected family members may vary widely, while those who are just carriers of the disorder may never develop dystonia themselves.
Cervical dystonia can lead to a number of other problems. These include cervical spine arthritis (inflammation of the facet joints), nerve root compression, and bone spurs that lead to cervical stenosis, a narrowing of the spinal canal that further crowds sensitive nerves. Compressed nerves may cause tingling, numbness, and weakness along their pathways in the body, such as into the arm and hand.
Pain is another major consequence. The repetitive jerking movements create pain on the same side as the head turn and deep within the compromised muscles. In severe cases, it can become disabling.
A small percentage of patients do experience a spontaneous remission after the first onset of symptoms, but it’s usually only temporary, and then the symptoms recur.
Botox® injections are the first line treatment for cervical dystonia. Botox is a neurotoxin derived from the bacterium Clostridium botulinum, the same toxin that causes food poisoning (botulism). According to the American Osteopathic College of Dermatology (AOCD), when used in a very diluted form by a trained and skilled practitioner, the toxin is safe and has few side effects.
Botox works by preventing the nerves from sending a signal to the muscles to contract. Without the stimulation, the muscles relax, preventing the characteristic spasms.
Botox injections only last for 3-4 months, so you’ll need to schedule regular injections to keep the spasms under control.
The FDA hasn’t approved any oral medications for cervical dystonia, though some physicians use medications that target the neurotransmitters dopamine and acetylcholine “off-label” to treat symptoms. Unfortunately, adverse side effects usually appear before reaching a therapeutic dose, which limits their effectiveness.
Deep brain stimulation (DBS) may be an appropriate alternative treatment for patients who lose their response to Botox, or who have a form of dystonia that’s difficult to treat with the injections. DBS involves placing electrodes (thin wires) into the brain that send out small electrical pulses to regulate transmitters. While these pulses appear to “reset” the brain and relieve dystonic movements, the mechanism of action isn’t well understood.
Are you experiencing symptoms of cervical dystonia and need relief? Your next stop should be Memphis Neurology for an evaluation, diagnosis, and effective treatment. Give us a call at either our Germantown, Tennessee, or Southaven, Mississippi, office to set up a consultation with a neurologist, or book your appointment online with us today.