Cervical Dystonia (CD)

Cervical dystonia (CD) is a focal dystonia. It is also known as spasmodic torticollis and is characterized by abnormal movements or postures of the neck and head. It is considered the most common form of focal dystonia. Although CD may become apparent at any age, symptoms usually begin between the ages 20 to 60 years. Women are affected approximately twice as commonly as men.

The dystonic spasms of CD affect any combination of neck (cervical) muscles, resulting in jerky head movements or periodic or sustained unnatural position of the head . There is also sideways or lateral rotation of the head and twisting or torticollis of the neck, often with head tilt. There may be isolated turning, flexing, or extending of the neck to the side (laterocollis), front (anterocollis), or back (retrocollis). One shoulder may be elevated and displaced forward on the side toward which the chin turns. In addition, there is often mild associated dystonia in the upper arm muscles on the same side (segmental dystonia).

Symptoms of CD often worsen while walking or during stress. Symptoms typically improve with rest or sleep. In addition, CD is the most common focal dystonia that responds to sensory tricks. For example, patients with CD may place their hand on the side of their face, chin, or the back of the head. This may reduce the intensity of dystonic spasms. Lightly touching or applying pressure to certain areas of the head on the side that is opposite to that which the head is turned may temporarily allow correction of abnormal head position. The reason why sensory tricks work for some patients is not fully understood.

Over two-thirds of patients, particularly those with sustained head deviation, have associated neck pain. About one-third also experience head tremor (i.e., dystonic tremor), hand tremor, or both. Approximately 20 percent of patients with CD also have dystonic spasms of the eyelids (blepharospasm) or other muscles or of muscle groups of the arm or hand.

Evidence suggests that about 10 percent of those with cervical dystonia may have brief, spontaneous remissions. An additional 10 percent, particularly patients with an earlier age at symptom onset, may have longer remissions of about 2 to 3 years, typically beginning during the first few years following disease onset.

Please see the WE MOVE section on Cervical Dystonia.

	Blepharospasm