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Cervical Dystonia (Spasmodic Torticollis)

Focal dystonia of neck muscles causing involuntary head and neck postures.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

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What is Cervical Dystonia (Spasmodic Torticollis)?

Cervical dystonia (spasmodic torticollis) is a focal movement disorder characterized by involuntary, sustained, or intermittent contractions of neck and shoulder muscles producing abnormal head postures (rotation, tilt, flexion, extension) and often associated pain.

It is the most common adult-onset focal dystonia, typically presenting in the 4th-6th decade with female predominance. Pathophysiology involves dysfunction of basal ganglia circuits, cortical excitability changes, and sensorimotor integration abnormalities.

Diagnosis is clinical based on characteristic posture and movement features, with examination for sensory tricks (geste antagoniste). Botulinum toxin injection into involved muscles is first-line therapy. Selective denervation surgery and deep brain stimulation are reserved for refractory cases.

Symptoms

Involuntary head turning, tilting or flexion
Neck and shoulder pain
Tremor in head movement
Sensory geste (touching face for relief)
Worsening with stress and fatigue
Improvement during sleep
Secondary muscle hypertrophy

Risk Factors

Female sex
Genetic predisposition (DYT1, DYT6)
Family history of dystonia
Trauma or peripheral nerve injury
Drug-induced (antipsychotics, metoclopramide)
Onset in 4th-6th decade
Coexisting tremor

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent abnormal head posture
  • Painful neck spasms
  • Functional impairment from posture
  • Failed simple measures
  • Suspected drug-induced dystonia
  • Need for botulinum toxin therapy

Treatment Methods

01
Botulinum toxin injection (every 3-4 months)
02
Anticholinergics (trihexyphenidyl)
03
Benzodiazepines
04
Baclofen
05
Physical therapy and stretching
06
Selective denervation surgery
07
Deep brain stimulation for refractory cases

Which Department to Visit?

You can visit our Nöroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.