Cervical Dystonia

What is cervical dystonia?

Cervical dystonia is a painful condition where neck muscles contract involuntarily. This may cause your head and neck to twist, turn and possibly tilt forwards or backwards. It may also result in a neck that feels stiff with restricted range of movement. Frequently it causes headache, migraine and neck pain. Whilst it may occur following injury or illness to the brain and spinal cord, the cause is often unknown.

Common postures in cervical dystonia

Postures that affect both the neck and head simultaneously are referred to as laterocollis, torticollis, anterocollis and retrocollis.

Sometimes only the position of the head is affected. These postures are known as laterocaput, torticaput, antecaput and retrocaput.

Usually though, there is a combination of at least 2 different postures.

Botulinum toxin injections

Botulinum toxin is a purified protein that is extracted from bacteria under controlled laboratory conditions. The brands available are Botox^®, Dysport^® and Xeomin^®. Injection of botulinum toxin into the affected muscles of the neck is a common medical procedure to treat cervical dystonia. There are many important anatomical structures around the neck, so ultrasound is used to visualise and guide the injections.

Once injected the medication blocks the release of acetylcholine, a neurotransmitter, from the nerve which then allows muscle fibres to gradually relax. It takes 1-2 weeks for this change to commence. The medication remains active for at least 3 months 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 often improve following treatment.

Botulinum toxin is listed on the Pharmaceutical Benefits Scheme for the treatment of cervical dystonia. This means it can be accessed at little or no cost to the patient.