Cervical Dystonia
What is cervical dystonia?
Cervical dystonia is a neurological movement disorder that causes neck muscles to contract involuntarily. The exact cause is often unknown, but it is thought to involve abnormal signals between areas of the brain that control movement. On occasion, cervical dystonia may be associated with neck injury, brain injury, cerebral palsy, stroke and parkinson’s disease. Maintaining good posture is crucial, as prolonged, fixed positions can worsen the pain. Cervical dystonia significantly impacts quality of life but fortunately treatment is available.
Common symptoms in cervical dystonia
Cervical dystonia may cause or be associated with any of the following symptoms:
- abnormal posture of the neck and head (for example torticollis),
- neck muscle spasm,
- neck stiffness with restricted range of movement,
- neck pain,
- headache or migraine,
- head tremor,
- thoracic outlet syndrome,
- bruxism (teeth grinding) or temporomandibular joint (TMJ) dysfunction.
Botulinum toxin injections
Botulinum toxin is a purified protein extracted under controlled laboratory conditions. Available brands are Botox®, Dysport® and Xeomin®. Injection of botulinum toxin into the affected muscles of the neck is a common medical procedure and is gold-standard for treatment of cervical dystonia. Dr Jennings-Bell has pioneered the use of ultrasound in treating cervical dystonia.
Once injected the botulinum toxin blocks the release of acetylcholine, a neurotransmitter, from the nerve which then allows muscle fibres to gradually relax. It takes a few days for this change to commence. The medication remains active for 12 weeks and repeat injections are usually required for ongoing clinical benefit. For cervical dystonia, it often takes a few treatment cycles to provide significant relief. Interestingly, if headache, migraine or neck pain occur in association with cervical dystonia, these symptoms also often improve following treatment.
Botulinum toxin is listed on the Pharmaceutical Benefits Scheme for the treatment of cervical dystonia. This means the medication can be accessed with little cost to the patient.
Goals of treatment
Common goals for patients with cervical dystonia may include:
- Improve neck position
- Improve neck range of movement
- Improve quality of life
- Reduce headache, migraine and neck pain
- Reduce pain medications
- Reduce the risk of falls
