Summary about Disease
Spasmodic torticollis, also known as cervical dystonia, is a painful neurological movement disorder that causes the neck muscles to contract involuntarily, resulting in the head twisting or turning to one side, or tilting forward or backward. It can range in severity from mild to severe, impacting daily activities and quality of life. The condition is chronic, meaning it's long-lasting.
Symptoms
The primary symptom is involuntary muscle contractions in the neck. These contractions can cause:
Head twisting to one side (rotational torticollis)
Head tilting forward (anterocollis)
Head tilting backward (retrocollis)
Head tilting to the side (laterocollis)
Neck pain and stiffness
Shoulder elevation
Tremors (shaking) in the head or neck
Headaches Symptoms can be continuous or intermittent and may worsen with stress or fatigue.
Causes
The exact cause of spasmodic torticollis is often unknown. It's believed to involve problems in the basal ganglia, a part of the brain that controls movement. Factors that may contribute include:
Genetic factors: In some cases, there's a family history of dystonia.
Brain injury: Trauma to the head or neck can sometimes trigger the condition.
Certain medications: Rarely, certain drugs may be linked to dystonia.
Other neurological conditions: Parkinson's disease or other neurological disorders can sometimes be associated.
Idiopathic: In many cases, no specific cause can be identified.
Medicine Used
Several medications can help manage the symptoms of spasmodic torticollis:
Botulinum toxin injections (Botox, Dysport): This is the most common treatment. Injections into the affected neck muscles weaken them, reducing spasms and pain.
Oral medications:
Muscle relaxants (e.g., baclofen)
Anticholinergics (e.g., trihexyphenidyl)
Dopamine-depleting agents (e.g., tetrabenazine)
Analgesics (pain relievers)
Deep Brain Stimulation (DBS): For severe cases that do not respond to other treatments, DBS, a surgical procedure, may be considered.
Is Communicable
No, spasmodic torticollis is not communicable or contagious. It is not an infection and cannot be spread from person to person.
Precautions
While there's no way to prevent spasmodic torticollis, these precautions can help manage symptoms and improve quality of life:
Regular exercise: Gentle stretching and exercises can help maintain neck flexibility and reduce stiffness.
Good posture: Maintaining good posture can minimize strain on neck muscles.
Stress management: Stress can worsen symptoms, so relaxation techniques like yoga, meditation, or deep breathing can be helpful.
Physical therapy: A physical therapist can provide exercises and strategies to improve neck mobility and reduce pain.
Ergonomic adjustments: Adjusting your workstation to promote good posture can help.
How long does an outbreak last?
Spasmodic torticollis is a chronic condition, not an "outbreak". Symptoms can fluctuate in severity over time, with periods of worsening (exacerbations) and periods of improvement. Without treatment, it is a life long condition.
How is it diagnosed?
Diagnosis typically involves:
Physical examination: A doctor will assess your posture, range of motion, and neck muscle contractions.
Neurological examination: This helps rule out other neurological conditions.
Medical history: The doctor will ask about your symptoms, family history, and any medications you're taking.
Electromyography (EMG): This test measures the electrical activity of muscles and can help confirm the diagnosis and identify the affected muscles.
MRI Scan: MRI is usually done to rule out other reasons for dystonia
Timeline of Symptoms
The onset of symptoms can be gradual or sudden.
Early stages: Symptoms may be mild and intermittent, with occasional neck stiffness or discomfort.
Progression: Over time, symptoms typically worsen, with more frequent and severe muscle contractions. The head may be pulled into a more pronounced and sustained abnormal position.
Plateau: In some cases, symptoms may stabilize after a period of progression.
Fluctuations: Symptoms can fluctuate in severity, with periods of remission and exacerbation.
Important Considerations
Living with spasmodic torticollis can be challenging: It can affect daily activities, work, and social life.
Early diagnosis and treatment are important: Prompt intervention can help manage symptoms and improve quality of life.
Support groups can be helpful: Connecting with others who have the condition can provide emotional support and practical advice.
Mental health is important: Chronic pain and disability can contribute to depression and anxiety. Seeking mental health support is crucial.
Find a specialist: Consult with a neurologist or movement disorder specialist experienced in treating dystonia.