Neck Dystonia
It is the most common case of localized dystonia, of unknown cause, which occurs between the ages of 30-50 years, without excluding its appearance either earlier or later. Some cases have a genetic basis, but the correlation is not yet clear. Apart from idiopathic reasons, there is a chance that is caused by the action of some drugs, some toxins as well as degenerative cerebral diseases. It refers to involuntary muscular contractures in throat muscles, which are either continuous or appear as spasms. The progression is unpredictable and varies from person to person. Many times dystonia appears as a symptom of other disease.
Symptoms
They may slowly progress. Muscular contractures of neck muscles lead to characteristic head positions, with the most frequent being squamous, ie turning chin to one shoulder so that the head is turned both sides (toricollis). However, the head may move forward (anterocollis), or behind (retrocollis) or to one side (laterocollis). There may also be a head lift over the shoulders either forward or backward. Generally, there is a combination of movements with different tilt angles. Perhaps there is tremor in hands. These symptoms may get worse due to anxiety or intense emotions and triggered by specific body postures. They may be improved by specific manipulations, such as touching the chin or the back of the head.
There is the possibility of complications such as cervical stenosis, cervical arthritis and nerve compression.
Pain is located on the head-turning side, where muscles overfunction and is perceived as muscle pain that can be severe and cause disability.
Diagnosis
Personal medical history.
Clinical tests.
Management
There is no cure, but a strategy of treating symptoms and palliative care of contractures is followed. There are three possible approaches including the injection of botulinum, oral medication and nerve surgery, whether done alone or in combination.
Physiotherapy is also recommended.
Information about clinical trials conducted globally: https://www.centerwatch.com/clinical-trials/listings/condition/58/dystonias/ and https://clinicaltrials.gov/ct2/home
References
- Jinnah, Diagnosis & Treatment of Dystonia, Neurol Clin., 2015, 33, 1, pp.77–100.
- Neck Dystonia, Dystonia Society, http://www.dystonia.org.uk/index.php/about-dystonia/types-of-dystonia/neck-dystonia
- NORD (National Organization for Rare Disorders), rare diseases, https://rarediseases.org/rare-diseases/