Cervical Dystonia

What is cervical dystonia?

Cervical dystonia is a disabling movement disorder in which sustained or repetitive neck muscle contractions occur involuntarily. Whilst it may occur following injury, the cause is often unknown.

Common symptoms in cervical dystonia

Cervical dystonia may cause one or a combination 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 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 a few days 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.