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Cervical dystonia

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Spasmodic torticollis (cervical dystonia) is a type of dystonia where there is spasmodic turning of the head and neck to one side. The muscles involved - trapezius and sternomastoid - may become hypertrophied. There may be dystonia elsewhere.

Prevalence of spasmodic torticollis is 0.006% (5.7 per 100,000) (1)





In the acute presentation there may be sudden pain and an inability to move the head. Commonly the condition occurs in the 15-30 age group. Passive and active movements are restricted. The head is typically held in a position flexed away from the pain.

  • spasmodic torticollis is a chronic neurological disorder characterized by involuntary contractions of the cervical musculature that lead to abnormal movements and postures of the head (2)
    • additional symptoms can include jerking movements, transient spasms, shoulder elevation, stiffness/tightness, and tremor
    • at least two-thirds of patients report pain that significantly contributes to the disability associated with their disorder
    • pain is most frequently localized to the back of the neck and shoulders
      • may also involve the head, upper chest, upper arms, and other areas

Spasmodic torticollis (cervical dystonia) is rarely self-limiting. Treatment options include botulinum toxin injections into the affected muscles.

Notes:

  • for information relating to acute wry neck (torticollis) see linked item

Reference:

  • (1) Epidemiological Study of Dystonia in Europe (ESDE) Collaborative Group. A prevalence study of primary dystonia in eight European countries. J Neurol 2000;247(10):787-92.
  • (2) Jankovic J et al. Cervical dystonia: clinical findings and associated movement disorders. Neurology 1991;41 (7): 1088-1091.

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