Materiały źródłowe

• #1 Cervical dystonia: Etiology, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/cervical-dystonia-etiology-clinical-features-and-diagnosis/print

  Cervical dystonia, also known as spasmodic torticollis or simply torticollis, is one of the most common adult-onset focal dystonias. […] The diagnosis is made primarily through awareness of the disorder and attention to detail during the neurologic examination. Ancillary testing is seldom necessary to establish an accurate diagnosis.

• #2 Adult-Onset Idiopathic Cervical Dystonia – European Medical Journal

  https://www.emjreviews.com/neurology/article/adult-onset-idiopathic-cervical-dystonia-j190422/

  Adult-onset idiopathic focal dystonia is the most common type of primary dystonia, and adult-onset idiopathic cervical dystonia (AOICD) is its most prevalent phenotype. […] Motor symptoms at presentation are poorly recognised by non-specialists, leading to long delays in diagnosis. Certain features of history and examination can help diagnose cervical dystonia. […] Comprehensive modern management of patients with AOICD requires recognition of presence of mood disorders, and actively treating the endogenous mood disorder with antidepressant therapy. […] Cervical dystonia (CD) is the most common expression of AOIFD, characterised by sustained, involuntary contractions of the cervical neck muscles. […] Delays in diagnosis complicate research into cervical dystonia, and accurate assessment of age of onset can be difficult. This disorder is poorly recognised.

• #3 Cervical Dystonia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/25228-cervical-dystonia

  Cervical dystonia is a neurological condition (affecting your brain and nerves) that causes involuntary muscle contractions in your neck. […] A healthcare provider will diagnose cervical dystonia after a physical exam to review your symptoms. […] Testing, like an MRI or electromyography, isnt necessary unless your healthcare provider suspects spinal cord compression or nerve damage or irritation. […] Treatment for cervical dystonia may include: Botulinum toxin injections, Oral medications, Physical therapy, Deep brain stimulation surgery. […] Many people know about a common brand of botulinum toxin called Botox. This is a type of botulinum toxin serotype A that can treat cervical dystonia in addition to botulinum toxin type B. […] Your healthcare provider will inject this medication into the muscles in your neck.

• #4 Cervical Dystonia – Brain, Spinal Cord, and Nerve Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/movement-disorders/cervical-dystonia

  Doctors base the diagnosis on symptoms and results of the physical examination. […] The diagnosis of cervical dystonia is based on symptoms and a neurologic examination.

• #5 Current Guidelines for Classifying and Diagnosing Cervical Dystonia: Empirical Evidence and Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8810420/

  The dystonias are phenotypically and etiologically heterogenous disorders. Many proposals and a consensus recommendation have been provided for the diagnosis and classification of the dystonias, but these recommendations serve only as general guidelines. Current diagnosis and classification may still depend on clinical judgment causing different opinions. […] Although cervical dystonia (CD) is the most common of all dystonias, there are no widely accepted diagnostic criteria. Some criteria have been proposed, but they have not yet been validated. Furthermore, these criteria do not delineate focal from broader patterns of involvement, such as segmental or multifocal dystonia. The current study provides an in depth analysis of a large multicenter cohort focusing on the diagnosis of CD, and particularly its classification according to body regions affected.

• #6 Cervical dystonia: Etiology, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/cervical-dystonia-etiology-clinical-features-and-diagnosis/print

  Cervical dystonia, also known as spasmodic torticollis or simply torticollis, is one of the most common adult-onset focal dystonias. […] The diagnosis is made primarily through awareness of the disorder and attention to detail during the neurologic examination. Ancillary testing is seldom necessary to establish an accurate diagnosis.

• #7 Diagnosis of Dystonia – Dystonia Ireland

  https://www.dystonia.ie/about-dystonia/diagnosis-of-dystonia/

  There is no single test to confirm the diagnosis of dystonia. To avoid misdiagnosis it is important that the G.P. refers the patient with dystonia to a neurologist specialising in movement disorders to observe symptoms of dystonia and obtain a detailed patient and family history and do a thorough clinical evaluation. In order to correctly diagnose dystonia, doctors must be able to recognise the physical signs and be familiar with the symptoms. […] The kind of specialist who typically has the training to diagnose and treat dystonia is a movement disorder neurologist, an ophthalmologist to treat Blepharospasm and an ENT specialist (ear, nose and throat) should be consulted to treat spasmodic dysphonia. […] The dystonia diagnostic process may include: Patient history, Family history, Laboratory studies such as blood and urine tests, and analysis of cerebrospinal fluid, Electrical recording techniques, such as electromyography (EMG) or electroencephalography (EEG), Genetic testing for specific forms of dystonia, Other tests and screenings intended to rule out other conditions or disorders.

• #8 Dystonia Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/dystonia

  Dystonia takes so many forms and has so many underlying causes, and its onset can be so slow, that it is commonly misdiagnosed by non-specialists. […] The first steps in diagnosing dystonia are usually conducting a physical examination and taking a medical history. In the medical history, the doctor will be especially interested in getting a complete list of any drugs and medications the patient has taken, and in discovering whether there is any family history of movement disorders. […] Blood tests or brain scans are sometimes helpful in identifying the underlying cause of the condition.

• #9 Cervical Dystonia |

  https://sydneynorthneurology.com.au/cervical-dystonia/

  Associate Professor Karl Ng has interest in the diagnosis and management of cervical dystonia including the use of medical injectable therapies. […] The first step a doctor will take to diagnose CD is to obtain a detailed medical history, including any past trauma or injury and any balance issues. This will help to identify tardive dystonia caused by medications or toxins, which is the most common cause of CD. The doctor will ask you to describe your symptoms. Commonly, people with early CD complain of a stiff neck as well as involuntary twisting of the neck that feels like it is being pulled. […] If the CD is primary, there are few options for further investigation, as laboratory tests and neuroimaging will not provide much more information. […] During clinical examination, the overactive muscles involved in the postural abnormality will be identified by evaluating the range of motion and movement patterns of the head, neck and shoulders. […] Cervical dystonia / torticollis

• #10 Cervical dystonia: what does the examination look for? – Infodystonia

  https://infodystonia.com/2011/11/02/cervical-dystonia-what-does-the-examination-look/

  Cervical dystonia: what does the examination look for? Dr Marion tells you how the clinical examination is important to optimise the Botox treatment. […] The diagnosis of cervical dystonia is made on the involuntary movement and the abnormal posture of the head, and often delays by many years from the onset of symptoms. […] But like the BSP, every patient is different and need to be examined carefully to document precisely the abnormal dystonic posture to know which muscle is pulling too much! […] Then when the posture is clearly documented, identifying which are the leading muscles behind, is based on surface anatomy (palpation) and functional anatomy (which muscle is doing what!).

• #11 Cervical Dystonia |

  https://sydneynorthneurology.com.au/cervical-dystonia/

  Associate Professor Karl Ng has interest in the diagnosis and management of cervical dystonia including the use of medical injectable therapies. […] The first step a doctor will take to diagnose CD is to obtain a detailed medical history, including any past trauma or injury and any balance issues. This will help to identify tardive dystonia caused by medications or toxins, which is the most common cause of CD. The doctor will ask you to describe your symptoms. Commonly, people with early CD complain of a stiff neck as well as involuntary twisting of the neck that feels like it is being pulled. […] If the CD is primary, there are few options for further investigation, as laboratory tests and neuroimaging will not provide much more information. […] During clinical examination, the overactive muscles involved in the postural abnormality will be identified by evaluating the range of motion and movement patterns of the head, neck and shoulders. […] Cervical dystonia / torticollis

• #12 Cervical Dystonia Symptoms, Diagnosis & Treatment | Pacific Movement Disorders

  https://www.pacificneuroscienceinstitute.org/movement-disorders/conditions/dystonia/cervical-dystonia/

  Cervical dystonia (sometimes called neck dystonia) is the abnormal position of the muscles of the neck, causing a twisted, turned, flexed or extended neck position. […] Patient unfamiliarity is expected and common but unfortunately physician lack of recognition is an issue as well. […] In addition to neck pain, many patients may manifest with a isolated head tremor (meaning tremor involving the head and neck and not involving the arms or legs). […] Typically, cervical dystonia is diagnosed based on the clinical exam. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), is a highly specialized rating scale used to precisely define the type and severity of cervical dystonia, typically with a video documentation after obtaining patient consent. […] In patients with young-onset dystonia, especially if there is involvement of the lower extremities and improvement after sleep, a levodopa trial is warranted where a dramatic response to levodopa would be expected if the diagnosis is dopa-responsive dystonia (aka Segawa syndrome). […] In some cases an MRI of the brain and blood or urine tests may be advised to exclude any other causes of adult-onset idiopathic (primary) cervical dystonia.

• #13 Clinical Diagnostic Evaluation of Dystonia

  https://practicalneurology.com/diseases-diagnoses/movement-disorders/clinical-diagnostic-evaluation-of-dystonia/32167/

  A thorough patient history and examination are needed to establish the clinical diagnosis of dystonia; subsequent laboratory, imaging, and genetic testing can assist in identification of etiology and a course of treatment. […] Recognizing dystonia can be a challenge, but its identification is an important first step in discerning an etiology and suggesting a course of treatment. […] Careful attention to patient history will highlight features that are consistent with dystonia or point to another diagnosis. […] The presence of a sensory trick can support the diagnosis of dystonia. People with cervical dystonia may find relief from lightly touching their face or the back of their head. […] If the predominant movement is diagnosed as dystonia, the next step is determining an etiology.

• #14 Clinical Diagnostic Evaluation of Dystonia

  https://practicalneurology.com/articles/2024-sept-oct/clinical-diagnostic-evaluation-of-dystonia

  A thorough patient history and examination are needed to establish the clinical diagnosis of dystonia; subsequent laboratory, imaging, and genetic testing can assist in identification of etiology and a course of treatment. […] Recognizing dystonia can be a challenge, but its identification is an important first step in discerning an etiology and suggesting a course of treatment. […] The presence of a sensory trick can support the diagnosis of dystonia. People with cervical dystonia may find relief from lightly touching their face or the back of their head. […] If the predominant movement is diagnosed as dystonia, the next step is determining an etiology. The characteristics gathered through the history and examination should be used to direct laboratory and imaging evaluations if necessary to establish whether the etiology is inherited, acquired, or idiopathic.

• #15 Adult-Onset Idiopathic Cervical Dystonia – European Medical Journal

  https://www.emjreviews.com/neurology/article/adult-onset-idiopathic-cervical-dystonia-j190422/

  Patients with CD frequently show an irregular, arrhythmic, spasmodic jerking movement of the head with slower recovery phases towards the neutral position. […] Specific symptoms, pain, and social anxiety associated with these should be probed in patients for targeted treatments. […] Pain is a prominent symptom and can affect the majority of patients with CD. […] Anxiety and/or depression are important features of AOIFD. […] Clinicians treating patients with AOIFD should be cognisant that dystonia is more than a motor disorder. […] Botulinum toxin (BoNT) is the most effective treatment for focal dystonias. […] With careful muscle selection and accurate injections, CD can be treated very effectively. […] A holistic approach, with multidisciplinary input, including physiotherapists, occupational therapists, and psychologists, would be most effective in improving QoL.

• #16 Adult-Onset Idiopathic Cervical Dystonia – European Medical Journal

  https://www.emjreviews.com/neurology/article/adult-onset-idiopathic-cervical-dystonia-j190422/

  Patients with CD frequently show an irregular, arrhythmic, spasmodic jerking movement of the head with slower recovery phases towards the neutral position. […] Specific symptoms, pain, and social anxiety associated with these should be probed in patients for targeted treatments. […] Pain is a prominent symptom and can affect the majority of patients with CD. […] Anxiety and/or depression are important features of AOIFD. […] Clinicians treating patients with AOIFD should be cognisant that dystonia is more than a motor disorder. […] Botulinum toxin (BoNT) is the most effective treatment for focal dystonias. […] With careful muscle selection and accurate injections, CD can be treated very effectively. […] A holistic approach, with multidisciplinary input, including physiotherapists, occupational therapists, and psychologists, would be most effective in improving QoL.

• #17 Dystonia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dystonia/diagnosis-treatment/drc-20350484

  To diagnose dystonia, your healthcare team starts with a medical history and physical exam. […] To look for conditions that may be causing your symptoms, you might need: Blood or urine tests. These tests can reveal signs of toxins or of other conditions. MRI or CT scan. These imaging tests look for changes in your brain, such as tumors or evidence of a stroke. Electromyography (EMG). This test measures the electrical activity within muscles. Genetic testing. Some forms of dystonia are associated with certain genes. Knowing if you have these genes can help guide treatment. […] If your symptoms are serious, surgery might help. There are a few types of surgery to treat dystonia: Deep brain stimulation. Electrodes are surgically implanted into a specific part of your brain and connected to a generator implanted in your chest. The generator sends electrical pulses to your brain that might help control your muscle contractions. The settings on the generator can be adjusted to treat your specific condition. Selective denervation surgery. This procedure involves cutting the nerves that control muscle spasms. It might be an option when other treatments for cervical dystonia haven’t worked.

• #18 Cervical Dystonia

  https://www.aapmr.org/about-physiatry/conditions-treatments/pain-neuromuscular-medicine-rehabilitation/cervical-dystonia

  Condition: Cervical Dystonia (CD) is a condition affecting head or neck muscles caused by localized abnormal muscle activity. […] Diagnostic Process: CD is a clinical diagnosis. This means that there is no one test or tests that can be ordered to prove that CD is present. Your doctor may request one or more studies including blood tests, X-rays, MRI or muscle and nerve tests to help eliminate other conditions that may mimic CD. Additionally, genetic testing can be considered for the above-mentioned genetic variants.

• #19 Dystonia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dystonia/diagnosis-treatment/drc-20350484

  To diagnose dystonia, your healthcare team starts with a medical history and physical exam. […] To look for conditions that may be causing your symptoms, you might need: Blood or urine tests. These tests can reveal signs of toxins or of other conditions. MRI or CT scan. These imaging tests look for changes in your brain, such as tumors or evidence of a stroke. Electromyography (EMG). This test measures the electrical activity within muscles. Genetic testing. Some forms of dystonia are associated with certain genes. Knowing if you have these genes can help guide treatment. […] If your symptoms are serious, surgery might help. There are a few types of surgery to treat dystonia: Deep brain stimulation. Electrodes are surgically implanted into a specific part of your brain and connected to a generator implanted in your chest. The generator sends electrical pulses to your brain that might help control your muscle contractions. The settings on the generator can be adjusted to treat your specific condition. Selective denervation surgery. This procedure involves cutting the nerves that control muscle spasms. It might be an option when other treatments for cervical dystonia haven’t worked.

• #20 Dystonia: What It Is, Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/6006-dystonia

  How is dystonia diagnosed? A healthcare provider, often a neurologist, can diagnose dystonia based on your symptoms, a neurological exam and various medical tests. Diagnosing dystonia is often tricky because its symptoms can happen with so many other conditions. That means its important to rule out those other conditions, some of which are life-threatening medical emergencies. […] What tests will be done to diagnose dystonia? A wide range of lab, diagnostic and imaging tests are possible with dystonia. The most likely tests depend on your symptoms and what conditions healthcare providers suspect. Possible tests include, but arent limited to, the following: Blood tests (these can detect many problems, ranging from immune system issues to toxins and poisons, especially metals like copper or manganese). Computerized tomography (CT) scan. Electroencephalogram (EEG). Electromyogram (nerve conduction test). Genetic testing. Magnetic resonance imaging (MRI). Positron emission tomography (PET) scan. Spinal tap (lumbar puncture). Other tests are possible, so your healthcare provider is the best person to ask about the tests they recommend for your specific case. The information they provide will be the most accurate for your circumstances.

• #21 Dystonia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dystonia/diagnosis-treatment/drc-20350484

  To diagnose dystonia, your healthcare team starts with a medical history and physical exam. […] To look for conditions that may be causing your symptoms, you might need: Blood or urine tests. These tests can reveal signs of toxins or of other conditions. MRI or CT scan. These imaging tests look for changes in your brain, such as tumors or evidence of a stroke. Electromyography (EMG). This test measures the electrical activity within muscles. Genetic testing. Some forms of dystonia are associated with certain genes. Knowing if you have these genes can help guide treatment. […] If your symptoms are serious, surgery might help. There are a few types of surgery to treat dystonia: Deep brain stimulation. Electrodes are surgically implanted into a specific part of your brain and connected to a generator implanted in your chest. The generator sends electrical pulses to your brain that might help control your muscle contractions. The settings on the generator can be adjusted to treat your specific condition. Selective denervation surgery. This procedure involves cutting the nerves that control muscle spasms. It might be an option when other treatments for cervical dystonia haven’t worked.

• #22 Cervical Dystonia: Diagnosis & Treatment Options

  https://lonestarneurology.net/blog/cervical-dystonia-treatment/

  Cervical dystonia is a type of dystonia in which the neck muscles are affected. Symptoms may include difficulty turning your head, neck pain, and headaches. If you are experiencing any of these symptoms, it is vital to see a doctor to diagnose and treat cervical dystonia. […] If you think you may have cervical dystonia, it is vital to seek medical help right away. If you go to a medical centre in time, you will get the proper treatment and avoid surgery for cervical dystonia. […] The doctor will perform a physical exam and ask questions about your symptoms. The doctor may also order an MRI or CT scan. That way, they can look for signs of a neck sprain or neurological problem. These cause neck spasms. […] You may also need other tests, such as blood or urine tests or electromyography (EMG). These tests will help determine if any underlying neurological problems may be causing your neck dystonia. Once the diagnosis is made, you can treat cervical dystonia.

• #23 Cervical Dystonia: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/dr/cervical-dystonia

  Cervical dystonia is a rare condition in which your neck muscles involuntarily contract into abnormal positions. […] The specific cause isnt known. […] According to a 2008 study, its important to use electrical signal diagnostics, or electromyography, to target the particular muscles for botulinum toxin injections. […] Treatment options for cervical dystonia have improved in recent years. […] When more conservative treatments dont work, surgical procedures may be an option. […] Cervical dystonia is a serious neurological disorder with no known cure as yet. […] Its likely that youll have a mix of treatments, including: botulinum toxin, physical therapy, counseling, surgery, in some cases. […] Possible complications include: the spread of involuntary motions to other parts of your body, bone spurs in the spine, cervical spine arthritis. […] People with cervical dystonia also have a higher risk of depression and anxiety.

• #24 Dystonia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dystonia/diagnosis-treatment/drc-20350484

  To diagnose dystonia, your healthcare team starts with a medical history and physical exam. […] To look for conditions that may be causing your symptoms, you might need: Blood or urine tests. These tests can reveal signs of toxins or of other conditions. MRI or CT scan. These imaging tests look for changes in your brain, such as tumors or evidence of a stroke. Electromyography (EMG). This test measures the electrical activity within muscles. Genetic testing. Some forms of dystonia are associated with certain genes. Knowing if you have these genes can help guide treatment. […] If your symptoms are serious, surgery might help. There are a few types of surgery to treat dystonia: Deep brain stimulation. Electrodes are surgically implanted into a specific part of your brain and connected to a generator implanted in your chest. The generator sends electrical pulses to your brain that might help control your muscle contractions. The settings on the generator can be adjusted to treat your specific condition. Selective denervation surgery. This procedure involves cutting the nerves that control muscle spasms. It might be an option when other treatments for cervical dystonia haven’t worked.

• #25 Dystonia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dystonia/diagnosis-treatment/drc-20350484

  To diagnose dystonia, your healthcare team starts with a medical history and physical exam. […] To look for conditions that may be causing your symptoms, you might need: Blood or urine tests. These tests can reveal signs of toxins or of other conditions. MRI or CT scan. These imaging tests look for changes in your brain, such as tumors or evidence of a stroke. Electromyography (EMG). This test measures the electrical activity within muscles. Genetic testing. Some forms of dystonia are associated with certain genes. Knowing if you have these genes can help guide treatment. […] If your symptoms are serious, surgery might help. There are a few types of surgery to treat dystonia: Deep brain stimulation. Electrodes are surgically implanted into a specific part of your brain and connected to a generator implanted in your chest. The generator sends electrical pulses to your brain that might help control your muscle contractions. The settings on the generator can be adjusted to treat your specific condition. Selective denervation surgery. This procedure involves cutting the nerves that control muscle spasms. It might be an option when other treatments for cervical dystonia haven’t worked.

• #26 Dystonia: What It Is, Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/6006-dystonia

  How is dystonia diagnosed? A healthcare provider, often a neurologist, can diagnose dystonia based on your symptoms, a neurological exam and various medical tests. Diagnosing dystonia is often tricky because its symptoms can happen with so many other conditions. That means its important to rule out those other conditions, some of which are life-threatening medical emergencies. […] What tests will be done to diagnose dystonia? A wide range of lab, diagnostic and imaging tests are possible with dystonia. The most likely tests depend on your symptoms and what conditions healthcare providers suspect. Possible tests include, but arent limited to, the following: Blood tests (these can detect many problems, ranging from immune system issues to toxins and poisons, especially metals like copper or manganese). Computerized tomography (CT) scan. Electroencephalogram (EEG). Electromyogram (nerve conduction test). Genetic testing. Magnetic resonance imaging (MRI). Positron emission tomography (PET) scan. Spinal tap (lumbar puncture). Other tests are possible, so your healthcare provider is the best person to ask about the tests they recommend for your specific case. The information they provide will be the most accurate for your circumstances.

• #27 Cervical Dystonia – Samir P. Macwan, MD

  https://socalmusclenerve.com/cervical-dystonia/

  Cervical dystonia is a neurological movement disorder that causes the muscles in your neck to contract (tighten) involuntarily. Cervical dystonia is characterized by involuntary muscle contractions in the neck that cause abnormal movements and postures of the neck and head. […] Diagnosis of cervical dystonia is based upon clinical examination, a detailed patient history, and knowledge of the disorder. No specific laboratory or imaging test confirms a diagnosis of cervical dystonia. There are no abnormalities in laboratory or imaging tests. […] Cervical dystonia is classified as an isolated dystonia if there are no other associated abnormal findings, such as spasticity, Parkinsonism or ataxia. Most isolated cervical dystonia had no identifiable underlying causes. However, in some cases, cervical dystonia can arise from another underlying cause and be considered secondary (occurring as consequence of another disorder or condition).

• #28 Cervical Dystonia Symptoms, Diagnosis & Treatment | Pacific Movement Disorders

  https://www.pacificneuroscienceinstitute.org/movement-disorders/conditions/dystonia/cervical-dystonia/

  Cervical dystonia (sometimes called neck dystonia) is the abnormal position of the muscles of the neck, causing a twisted, turned, flexed or extended neck position. […] Patient unfamiliarity is expected and common but unfortunately physician lack of recognition is an issue as well. […] In addition to neck pain, many patients may manifest with a isolated head tremor (meaning tremor involving the head and neck and not involving the arms or legs). […] Typically, cervical dystonia is diagnosed based on the clinical exam. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), is a highly specialized rating scale used to precisely define the type and severity of cervical dystonia, typically with a video documentation after obtaining patient consent. […] In patients with young-onset dystonia, especially if there is involvement of the lower extremities and improvement after sleep, a levodopa trial is warranted where a dramatic response to levodopa would be expected if the diagnosis is dopa-responsive dystonia (aka Segawa syndrome). […] In some cases an MRI of the brain and blood or urine tests may be advised to exclude any other causes of adult-onset idiopathic (primary) cervical dystonia.

• #29 How MYOBLOC Helps Treat Cervical Dystonia

  https://www.myoblochcp.com/for-cervical-dystonia

  MYOBLOC is the first FDA-approved neurotoxin for the treatment of cervical dystonia (abnormal head position/neck pain) and a proven botulinum toxin B. Explore the evidence behind its strong legacy that extends back to 2000. […] Many patients with cervical dystonia suffer a delayed diagnosis. Patients see ~3 providers before being correctly diagnosed. More common conditions are often suspected or diagnosed instead of cervical dystonia, at least initially. […] By recognizing characteristic clinical features, an informed provider can make a more rapid diagnosis. […] MYOBLOC has a distinct mechanism of action. For cervical dystonia, blocking ACh release inhibits muscle contraction and allows the injected muscle to assume a more normal tone. […] MYOBLOC has been evaluated in clinical studies for a range of adult patients with cervical dystonia.

• #30 Diagnosis and Treatment of Cervical Dystonia: Current and Emerging Approaches

  https://www.medscape.org/viewarticle/753547

  Cervical dystonia (CD) is a potentially disabling movement disorder associated with abnormal head posture and pain, for which diagnosis is commonly either missed or delayed. […] This activity outlines diagnosis and treatment practices that clinicians can implement for a successful, long-term CD management plan. […] Optimize the timely diagnosis of CD via patient history and neurologic examination.

• #31 Cervical Dystonia |

  https://sydneynorthneurology.com.au/cervical-dystonia/

  Associate Professor Karl Ng has interest in the diagnosis and management of cervical dystonia including the use of medical injectable therapies. […] The first step a doctor will take to diagnose CD is to obtain a detailed medical history, including any past trauma or injury and any balance issues. This will help to identify tardive dystonia caused by medications or toxins, which is the most common cause of CD. The doctor will ask you to describe your symptoms. Commonly, people with early CD complain of a stiff neck as well as involuntary twisting of the neck that feels like it is being pulled. […] If the CD is primary, there are few options for further investigation, as laboratory tests and neuroimaging will not provide much more information. […] During clinical examination, the overactive muscles involved in the postural abnormality will be identified by evaluating the range of motion and movement patterns of the head, neck and shoulders. […] Cervical dystonia / torticollis

• #32 Cervical Dystonia – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/movement-and-cerebellar-disorders/cervical-dystonia

  Cervical dystonia is characterized by involuntary tonic contractions or intermittent spasms of neck muscles. Diagnosis is clinical. […] The diagnosis of cervical dystonia is based on characteristic symptoms and signs and exclusion of alternative diagnoses, including the following: […] Diagnosis is clinical and involves exclusion of tardive dystonia, basal ganglia disorders, CNS infections, neck infections and tumors, and medications.

• #33 7 Everyday Questions about Cervical Dystonia – Pacific Neuroscience Institute

  https://www.pacificneuroscienceinstitute.org/blog/dystonia/7-everyday-questions-about-cervical-dystonia/

  Cervical dystonia is a painful condition that affects the neck and causes the head to tilt to one side, or causes the head to tremble. […] First off, make sure you are seen by a neurologist for a proper diagnosis. Unfortunately, cervical dystonia is very commonly misdiagnosed and patients may see five providers before getting a proper diagnosis. […] Cervical dystonia is usually lifelong, even though it does not begin until middle age (commonly). Cervical dystonia comes from the brain sending abnormal signals to the muscles, resulting in an incorrect set point. […] Many patients with cervical dystonia may experience lack of improvement or sometimes even in some cases worsening of their dystonia if they are being treated as if they had muscle spasm or degenerative disc disease. […] However, physical therapists with specialty in neurological disorders (neuro-PTs) are well versed in cervical dystonia and can definitely benefit, especially when combined with botulinum toxin injections.

• #34 Cervical Dystonia – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/movement-and-cerebellar-disorders/cervical-dystonia

  Cervical dystonia is characterized by involuntary tonic contractions or intermittent spasms of neck muscles. Diagnosis is clinical. […] The diagnosis of cervical dystonia is based on characteristic symptoms and signs and exclusion of alternative diagnoses, including the following: […] Diagnosis is clinical and involves exclusion of tardive dystonia, basal ganglia disorders, CNS infections, neck infections and tumors, and medications.

• #35 Cervical dystonia (spasmodic torticollis) | Dystonia Medical Research Foundation Canada

  https://dystoniacanada.org/about-dystonia/focal-dystonias/cervical-dystonia

  Cervical dystonia is among the most common forms of dystonia seen in movement disorder clinics. […] Diagnosis of cervical dystonia is based on information from the affected individual and the physical and neurological examination. At this time, there is no test to confirm diagnosis of cervical dystonia, and in most cases assorted laboratory tests are normal. […] Cervical dystonia should not be confused with other conditions which cause a twisted neck such as local orthopedic or congenital problems of the neck, or ophthalmologic conditions where the head tilts to compensate for impaired vision. It is sometimes misdiagnosed as stiff neck, arthritis, or wry neck.

• #36 Cervical Dystonia Treatments in Los Angeles | Neurological Associates

  https://www.neurologysantamonica.com/conditions/movement-disorders/cervical-dystonia/

  Cervical dystonia may be primary (meaning that it is the only apparent neurological disorder, with or without a family history) or be brought about by secondary causes such as physical trauma. […] Diagnosis of cervical dystonia is based on information from the affected individual and the physical and neurological examination. At this time, there is no test to confirm diagnosis of cervical dystonia, and in most cases assorted laboratory tests are normal. […] Cervical dystonia should not be confused with other conditions which cause a twisted neck such as local orthopedic or congenital problems of the neck, or ophthalmologic conditions where the head tilts to compensate for impaired vision. It is sometimes misdiagnosed as stiff neck, arthritis, or wryneck. […] At Neurological Associates The Interventional Group, our neurologists specialize in the treatment and diagnosis of cervical dystonia.

• #37 Cervical dystonia (spasmodic torticollis) | Dystonia Medical Research Foundation Canada

  https://dystoniacanada.org/about-dystonia/focal-dystonias/cervical-dystonia

  Cervical dystonia is among the most common forms of dystonia seen in movement disorder clinics. […] Diagnosis of cervical dystonia is based on information from the affected individual and the physical and neurological examination. At this time, there is no test to confirm diagnosis of cervical dystonia, and in most cases assorted laboratory tests are normal. […] Cervical dystonia should not be confused with other conditions which cause a twisted neck such as local orthopedic or congenital problems of the neck, or ophthalmologic conditions where the head tilts to compensate for impaired vision. It is sometimes misdiagnosed as stiff neck, arthritis, or wry neck.

• #38 What Is Cervical Dystonia? – Cervical Dystonia Treatment | familydoctor.org

  https://familydoctor.org/condition/cervical-dystonia/

  Cervical dystonia is a neurological disorder that causes the muscles in your neck to contract involuntarily. That means without you making them move. This muscle contraction can make your head lean or twist to one side. Your chin may pull up, down, forward, or backward. Your shoulder also can contort up. […] Your doctor will review your symptoms and perform a physical exam. They also will want to know about any health problems or disorders you may have. Your doctor may want to do some tests to see how your muscles work. These tests can detect the underlying cause of your muscle contractions. Cervical dystonia can resemble stiff neck, an acute pain, or spasm that goes away.

• #39 Cervical dystonia (spasmodic torticollis) | Dystonia Medical Research Foundation Canada

  https://dystoniacanada.org/about-dystonia/focal-dystonias/cervical-dystonia

  Cervical dystonia is among the most common forms of dystonia seen in movement disorder clinics. […] Diagnosis of cervical dystonia is based on information from the affected individual and the physical and neurological examination. At this time, there is no test to confirm diagnosis of cervical dystonia, and in most cases assorted laboratory tests are normal. […] Cervical dystonia should not be confused with other conditions which cause a twisted neck such as local orthopedic or congenital problems of the neck, or ophthalmologic conditions where the head tilts to compensate for impaired vision. It is sometimes misdiagnosed as stiff neck, arthritis, or wry neck.

• #40 Cervical Dystonia: Symptoms, Causes, Diagnosis and Treatment

  https://www.carehospitals.com/diseases-conditions/cervical-dystonia

  Doctors diagnose cervical dystonia through a comprehensive assessment of clinical manifestations. […] Medical History and Physical Evaluation: Doctors conduct a physical examination to review symptoms and inquire about the patient’s medical history, including any family history of the condition. During the consultation, doctors may ask about your symptoms, triggers, relieving factors, and ongoing medications. […] Additional Tests: Doctors might recommend additional tests to rule out underlying conditions. These may include: Blood tests, Magnetic Resonance Imaging (MRI), Neuroimaging is helpful in hemidystonia or generalised dystonia in adults due to a higher likelihood of disclosing structural causes. Doctors may recommend genetic testing for early-onset isolated dystonias. […] When cervical dystonia combines with other neurological or systemic features, additional workup is warranted. The specific laboratory tests depend on the associated features and age of onset.

• #41 Cervical dystonia and spasmodic torticollis treatment –

  https://caringmedical.com/prolotherapy-news/getting-help-cervical-dystonia-spastic-torticollis/

  Your journey started one day when you went to the doctor because you had painful, involuntary muscle spasms in the neck. […] Your doctor looked at you, noticed that your head is tilted, and felt your neck area for tightness and spasms. […] At this point, your medical journey began to accelerate. […] It is generally assumed that tremor, dystonia, tics, myoclonic jerking, chorea, cramps, dyskinesias, Meige syndrome (idiopathic cranial-cervical dystonia), disturbed eye movements, blepharospasms, torticollis, hemifacial spasm and many other unusual movement disorders are of central (brain) origin, with the physician and patient not considering a neck cause. […] We believe, in some cases, the condition is generally caused by a rotatory subluxation of C1-C2. […] The condition causes stiffness in the neck with muscle spasms, which develop into a dystonic or torticollis reaction.

• #42 Cervical dystonia and spasmodic torticollis treatment –

  https://caringmedical.com/prolotherapy-news/getting-help-cervical-dystonia-spastic-torticollis/

  This article will focused on the adult onset of the problem with cervical spine degeneration as its point of origin. […] In this article, you will come across the word idiopathic, the meaning of “unknown origin.” That is how your diagnosis may have been described, idiopathic cervical dystonia. […] While most of the movement disorder cases we see in our offices are thought to be idiopathic or of “no known cause,” it really means that the possibility of cervical ligament injury as the root cause has not been explored. […] If the answer to any or some of these questions is, “Yes,” then cervical ligament injury should be explored. […] Cervical dystonia is being caused by cervical spine instability brought on by weakened or damaged cervical ligaments. […] Back in 1993, at about the time we first opened our doors to cervical spine instability patients, doctors at the Mayo Clinic wrote about five patients in whom cervical dystonia developed immediately after relatively mild trauma to the neck.

• #43 Isolated Cervical Dystonia: Diagnosis and Classification

  https://digitalcommons.library.tmc.edu/baylor_docs/2437/

  This document presents a consensus on the diagnosis and classification of isolated cervical dystonia (iCD) with a review of proposed terminology. […] The International Parkinson and Movement Disorder Society Dystonia Study Group convened a panel of experts to review the main clinical and diagnostic issues related to iCD and to arrive at a consensus on diagnostic criteria and classification. […] The criteria aim to systematize the use of terminology as well as the diagnostic process, to make it reproducible across centers and applicable by expert and non-expert clinicians. […] Recognition of idiopathic iCD has two levels of certainty, definite or probable, supported by specific diagnostic criteria. […] Although a probable diagnosis is appropriate for clinical practice, a higher diagnostic level may be required for specific research studies. […] The consensus retains elements proven valuable in previous criteria and omits aspects that are no longer justified, thereby encapsulating diagnosis according to current knowledge. […] As understanding of iCD expands, these criteria will need continuous revision to accommodate new advances.

• #44 Isolated Cervical Dystonia: Diagnosis and Classification

  https://digitalcommons.library.tmc.edu/baylor_docs/2437/

  This document presents a consensus on the diagnosis and classification of isolated cervical dystonia (iCD) with a review of proposed terminology. […] The International Parkinson and Movement Disorder Society Dystonia Study Group convened a panel of experts to review the main clinical and diagnostic issues related to iCD and to arrive at a consensus on diagnostic criteria and classification. […] The criteria aim to systematize the use of terminology as well as the diagnostic process, to make it reproducible across centers and applicable by expert and non-expert clinicians. […] Recognition of idiopathic iCD has two levels of certainty, definite or probable, supported by specific diagnostic criteria. […] Although a probable diagnosis is appropriate for clinical practice, a higher diagnostic level may be required for specific research studies. […] The consensus retains elements proven valuable in previous criteria and omits aspects that are no longer justified, thereby encapsulating diagnosis according to current knowledge. […] As understanding of iCD expands, these criteria will need continuous revision to accommodate new advances.

• #45

  https://journals.lww.com/co-neurology/fulltext/2023/08000/new_developments_in_diagnostics_and_treatment_of.12.aspx

  Recently, the MDS has published a consensus statement regarding the classification of idiopathic cervical dystonia, differentiating between the two levels definite and probably idiopathic cervical dystonia. […] Supportive criteria and exclusion criteria for cervical dystonia diagnosis were identified. […] The development and use of universal clinical guidelines is important as it improves consistency and accuracy of diagnosis. […] A clinical diagnosis of adult-onset dystonia is generally based on phenomenology. Most cases are of idiopathic cause, requiring no further testing to establish a diagnosis. However, for a small percentage of patients, the dystonia is caused by a treatable underlying acquired or a genetic disease, thus prompt and accurate diagnosis is crucial in these cases. […] The authors conclude that genetic testing is currently not necessary if red flags for a genetic cause are lacking, and the phenotype of the patient truly matches that of adult-onset idiopathic focal dystonia.

• #46

  https://link.springer.com/article/10.1007/s00415-023-11585-6

  Cervical dystonia is characterized by a variable pattern of neck muscle involvement. Due to the lack of a diagnostic test, cervical dystonia diagnosis is based on clinical examination and is therefore subjective. The present work was designed to provide practical guidance for clinicians in confirming or refuting suspected cervical dystonia. […] Due to the lack of a diagnostic test, CD diagnosis is based on clinical examination and is therefore subjective. […] According to expert opinion, the clinical diagnosis of CD should rely on the core motor features highlighted in the revised definition of dystonia, and the exclusion of clinical red flags related to neurological/non-neurological conditions mimicking dystonia. […] An accurate diagnosis of cervical dystonia can be achieved if, in addition to the core motor features, we also consider some clinical features related to dystonia mimics that should be absent in dystonia.

• #47

  https://link.springer.com/article/10.1007/s00415-023-11585-6

  The best combination of sensitivity and specificity was observed when item 6 (capability to voluntarily suppress spasms) was excluded. […] This study demonstrates two relevant points. First, an accurate diagnosis of CD is not possible if we refer only to the core clinical feature of CD as proposed in the 2013 revised classification of dystonia, i.e., patterned and repetitive movements/postures in the head/neck as well as to the combination of this item and sensory trick. Second, a higher diagnostic accuracy can be achieved if we also consider clinical features related to dystonia mimics that should be absent in dystonia. The diagnostic algorithm without the item ability to voluntarily suppress spasms was sensitive and specific enough to be proposed as a guideline for presumptive diagnosis of CD, though it needs to be further expanded and validated in a larger international sample.

• #48

  https://link.springer.com/article/10.1007/s00415-023-11585-6

  The best combination of sensitivity and specificity was observed when item 6 (capability to voluntarily suppress spasms) was excluded. […] This study demonstrates two relevant points. First, an accurate diagnosis of CD is not possible if we refer only to the core clinical feature of CD as proposed in the 2013 revised classification of dystonia, i.e., patterned and repetitive movements/postures in the head/neck as well as to the combination of this item and sensory trick. Second, a higher diagnostic accuracy can be achieved if we also consider clinical features related to dystonia mimics that should be absent in dystonia. The diagnostic algorithm without the item ability to voluntarily suppress spasms was sensitive and specific enough to be proposed as a guideline for presumptive diagnosis of CD, though it needs to be further expanded and validated in a larger international sample.

• #49 Current Guidelines for Classifying and Diagnosing Cervical Dystonia: Empirical Evidence and Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8810420/

  Although CD is the most common dystonia in most movement disorders clinics, there are no widely accepted diagnostic criteria. There are recommendations for what delineates focal CD versus broader segmental or multifocal patterns of involvement. However, the most important finding from the current study is that these recommendations are not consistently followed. Specifically, there is a high frequency of dystonia outside of the neck region (28.2%) among patients classified by specialists in movement disorders as having focal CD. […] In accordance with current guidelines, we propose that the diagnosis and classification of focal CD be reserved for individuals with involvement of muscles that move the neck, with or without neck tremor. It is important to recognize that several muscles that move the neck can also move the shoulder.

• #50 Current Guidelines for Classifying and Diagnosing Cervical Dystonia: Empirical Evidence and Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8810420/

  Most investigators classified the combination of cervical and laryngeal dystonia as segmental, not focal dystonia. Although the larynx is obviously located in the neck, it has substantially different muscle control, innervation, and developmental origins. Therefore, a diagnosis of segmental dystonia seems more appropriate when there is cervical combined with laryngeal dystonia. […] A precise diagnosis is important for identifying clearly defined populations for many studies. It is important for treatment studies that involve patient-reported outcomes or quality of life for CD, because dystonia outside of the neck region may contribute to disability and therefore increase experimental variance when evaluating the effect of an intervention. A precise diagnosis is even more important for genetic studies, because a single incorrect diagnosis can dramatically alter outcomes. The results of the current study highlight several sources of inconsistency and provide recommendations to address them.

• #51 Cervical Dystonia Symptoms, Diagnosis & Treatment | Pacific Movement Disorders

  https://www.pacificneuroscienceinstitute.org/movement-disorders/conditions/dystonia/cervical-dystonia/

  Cervical dystonia (sometimes called neck dystonia) is the abnormal position of the muscles of the neck, causing a twisted, turned, flexed or extended neck position. […] Patient unfamiliarity is expected and common but unfortunately physician lack of recognition is an issue as well. […] In addition to neck pain, many patients may manifest with a isolated head tremor (meaning tremor involving the head and neck and not involving the arms or legs). […] Typically, cervical dystonia is diagnosed based on the clinical exam. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), is a highly specialized rating scale used to precisely define the type and severity of cervical dystonia, typically with a video documentation after obtaining patient consent. […] In patients with young-onset dystonia, especially if there is involvement of the lower extremities and improvement after sleep, a levodopa trial is warranted where a dramatic response to levodopa would be expected if the diagnosis is dopa-responsive dystonia (aka Segawa syndrome). […] In some cases an MRI of the brain and blood or urine tests may be advised to exclude any other causes of adult-onset idiopathic (primary) cervical dystonia.

• #52 How MYOBLOC Helps Treat Cervical Dystonia

  https://www.myoblochcp.com/for-cervical-dystonia

  Significant clinical efficacy in both Toxin A-responsive and -resistant cervical dystonia. […] TWSTRS is an assessment scale used to measure the impact of cervical dystonia on patients. It is frequently used in clinical trials for cervical dystonia, including trials for MYOBLOC. […] MYOBLOC provided significant pain reduction for both Toxin A-responsive and Toxin A-resistant patients at Week 4. […] Noninferiority of MYOBLOC vs. BOTOX was established in a head-to-head study. […] MYOBLOC has demonstrated tolerability.

• #53 Comprehensive diagnosis of cervical dystonia and the efficacy of long-term (three-year) botulinum therapy | Tolmacheva | Neurology, Neuropsychiatry, Psychosomatics

  https://nnp.ima-press.net/nnp/article/view/2102

  Cervical dystonia (CD) is common in outpatient practice but in many cases is diagnosed at late stages. The efficacy of long-term botulinum therapy (BT) in CD has been poorly studied. […] The diagnosis of CD was made on average 2.31.1 years after the onset of the first symptoms, BT was started on average 52.6 years after diagnosis. At the first visit to the physician, CD was detected in only 32% of cases. […] CD is still underdiagnosed in practice, and BT is not prescribed until several years after the onset of the disease. Regular and longterm use of BT not only reduces the severity of CD, but also reduces the severity of anxiety disorders and improves patients’ quality of life.

• #54 Adult-Onset Idiopathic Cervical Dystonia – European Medical Journal

  https://www.emjreviews.com/neurology/article/adult-onset-idiopathic-cervical-dystonia-j190422/

  Adult-onset idiopathic focal dystonia is the most common type of primary dystonia, and adult-onset idiopathic cervical dystonia (AOICD) is its most prevalent phenotype. […] Motor symptoms at presentation are poorly recognised by non-specialists, leading to long delays in diagnosis. Certain features of history and examination can help diagnose cervical dystonia. […] Comprehensive modern management of patients with AOICD requires recognition of presence of mood disorders, and actively treating the endogenous mood disorder with antidepressant therapy. […] Cervical dystonia (CD) is the most common expression of AOIFD, characterised by sustained, involuntary contractions of the cervical neck muscles. […] Delays in diagnosis complicate research into cervical dystonia, and accurate assessment of age of onset can be difficult. This disorder is poorly recognised.

• #55 Cervical Dystonia Symptoms, Diagnosis & Treatment | Pacific Movement Disorders

  https://www.pacificneuroscienceinstitute.org/movement-disorders/conditions/dystonia/cervical-dystonia/

  Cervical dystonia (sometimes called neck dystonia) is the abnormal position of the muscles of the neck, causing a twisted, turned, flexed or extended neck position. […] Patient unfamiliarity is expected and common but unfortunately physician lack of recognition is an issue as well. […] In addition to neck pain, many patients may manifest with a isolated head tremor (meaning tremor involving the head and neck and not involving the arms or legs). […] Typically, cervical dystonia is diagnosed based on the clinical exam. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), is a highly specialized rating scale used to precisely define the type and severity of cervical dystonia, typically with a video documentation after obtaining patient consent. […] In patients with young-onset dystonia, especially if there is involvement of the lower extremities and improvement after sleep, a levodopa trial is warranted where a dramatic response to levodopa would be expected if the diagnosis is dopa-responsive dystonia (aka Segawa syndrome). […] In some cases an MRI of the brain and blood or urine tests may be advised to exclude any other causes of adult-onset idiopathic (primary) cervical dystonia.

• #56 Cervical Dystonia | BOTOX ONE® | BOTOX® (onabotulinumtoxinA)

  https://www.botoxone.com/cervical-dystonia

  After over 20 years, BOTOX is still your trusted treatment for Cervical Dystonia1,2,* […] Cervical Dystonia (CD) patients may go several years before accurate diagnosis and treatment; often they may have milder or nonspecific symptoms.3,4 […] BOTOX is indicated for the treatment of adults with cervical dystonia to reduce the severity of abnormal head position and neck pain associated with cervical dystonia. […] BOTOX (onabotulinumtoxinA) for injection is indicated for the treatment of adults with cervical dystonia to reduce the severity of abnormal head position and neck pain associated with cervical dystonia. […] The most frequently reported adverse reactions following injection of BOTOX for cervical dystonia include dysphagia (19%), upper respiratory infection (12%), neck pain (11%), and headache (11%).

• #57 7 Everyday Questions about Cervical Dystonia – Pacific Neuroscience Institute

  https://www.pacificneuroscienceinstitute.org/blog/dystonia/7-everyday-questions-about-cervical-dystonia/

  Cervical dystonia is a painful condition that affects the neck and causes the head to tilt to one side, or causes the head to tremble. […] First off, make sure you are seen by a neurologist for a proper diagnosis. Unfortunately, cervical dystonia is very commonly misdiagnosed and patients may see five providers before getting a proper diagnosis. […] Cervical dystonia is usually lifelong, even though it does not begin until middle age (commonly). Cervical dystonia comes from the brain sending abnormal signals to the muscles, resulting in an incorrect set point. […] Many patients with cervical dystonia may experience lack of improvement or sometimes even in some cases worsening of their dystonia if they are being treated as if they had muscle spasm or degenerative disc disease. […] However, physical therapists with specialty in neurological disorders (neuro-PTs) are well versed in cervical dystonia and can definitely benefit, especially when combined with botulinum toxin injections.

• #58

  https://journals.lww.com/co-neurology/fulltext/2023/08000/new_developments_in_diagnostics_and_treatment_of.12.aspx

  Recently, the MDS has published a consensus statement regarding the classification of idiopathic cervical dystonia, differentiating between the two levels definite and probably idiopathic cervical dystonia. […] Supportive criteria and exclusion criteria for cervical dystonia diagnosis were identified. […] The development and use of universal clinical guidelines is important as it improves consistency and accuracy of diagnosis. […] A clinical diagnosis of adult-onset dystonia is generally based on phenomenology. Most cases are of idiopathic cause, requiring no further testing to establish a diagnosis. However, for a small percentage of patients, the dystonia is caused by a treatable underlying acquired or a genetic disease, thus prompt and accurate diagnosis is crucial in these cases. […] The authors conclude that genetic testing is currently not necessary if red flags for a genetic cause are lacking, and the phenotype of the patient truly matches that of adult-onset idiopathic focal dystonia.

• #59 Cervical dystonia and spasmodic torticollis treatment –

  https://caringmedical.com/prolotherapy-news/getting-help-cervical-dystonia-spastic-torticollis/

  They go on to describe: “Four of the five patients had persistent contractions of all cervical muscles including the trapezius muscles, which almost completely prevented motion of the neck and resulted in muscle hypertrophy. The condition persisted unabated in all patients for the entire period of follow-up (duration, 1 1/2 to 3 years).” […] Pharmaceutical interventions, which had been used previously for idiopathic nontraumatic cervical dystonia, failed to benefit these patients. […] Your doctor tells you that he/she suspects cervical dystonia or they may have called it Spastic Torticollis or Cervical Torticollis. […] Your doctor may suggest a specialist who can prescribe and recommend various muscle relaxants. […] In almost every movement disorder case that we have seen over the past 30 years, including the dystonias such as blepharospasm (repetitive forceful eyelid closure), spasmodic dysphonia affecting speech, oromandibular dystonia (tongue, jaw opening and jaw closing), and spasmodic torticollis, there is a history of traumatic injury to the neck.

• #60 Cervical dystonia and spasmodic torticollis treatment –

  https://caringmedical.com/prolotherapy-news/getting-help-cervical-dystonia-spastic-torticollis/

  Diagnosing the relationship between isolated head tremors and cervical dystonia. […] Identifying types of Idiopathic cervical dystonia. […] Cervical, oromandibular dystonia, and TMJ Disorders. […] The frequency and consequences of delayed Cervical dystonia diagnosis is poorly understood. […] It should be looked for more in women than men. […] It should be looked for in older patients. […] A diagnosis of Cervical dystonia was more common (or faster) when the patient had: essential tremor, cervical disc disease, neck sprain/strain, anxiety, and depression. […] This study concludes simply with: “Cervical dystonia incidence is greater in women and increases with age. Diagnostic delay is common and associated with adverse effects.” […] A November 2021 study in the medical journal Parkinsonism and Related Disorders wrote that isolated head tremor, a pathological condition characterized by head tremor without dystonic postures (tilt or twisted posture) or tremor in other body parts, has recently been suggested to be a form of dystonia. […] The researchers of this study also noted that it is still unclear whether isolated head tremor precedes dystonia or remains unmodified over time. […] The researchers concluded: “These findings will improve prognosis, treatment strategies and understanding of underlying disease mechanisms.”

• #61 Cervical dystonia and spasmodic torticollis treatment –

  https://caringmedical.com/prolotherapy-news/getting-help-cervical-dystonia-spastic-torticollis/

  Diagnosing the relationship between isolated head tremors and cervical dystonia. […] Identifying types of Idiopathic cervical dystonia. […] Cervical, oromandibular dystonia, and TMJ Disorders. […] The frequency and consequences of delayed Cervical dystonia diagnosis is poorly understood. […] It should be looked for more in women than men. […] It should be looked for in older patients. […] A diagnosis of Cervical dystonia was more common (or faster) when the patient had: essential tremor, cervical disc disease, neck sprain/strain, anxiety, and depression. […] This study concludes simply with: “Cervical dystonia incidence is greater in women and increases with age. Diagnostic delay is common and associated with adverse effects.” […] A November 2021 study in the medical journal Parkinsonism and Related Disorders wrote that isolated head tremor, a pathological condition characterized by head tremor without dystonic postures (tilt or twisted posture) or tremor in other body parts, has recently been suggested to be a form of dystonia. […] The researchers of this study also noted that it is still unclear whether isolated head tremor precedes dystonia or remains unmodified over time. […] The researchers concluded: “These findings will improve prognosis, treatment strategies and understanding of underlying disease mechanisms.”

• #62

  https://www.dystonia.org.uk/pages/faqs/category/neck-dystonia

  Cervical dystonia should be diagnosed and treated by a neurologist specialising in movement disorders. […] Symptoms usually appear between the ages of 30 and 50. […] It is the most common dystonia and affects an estimated 18,000 adults in the UK.

• #63

  https://www.dystonia.org.uk/pages/category/diagnosis-and-treatment

  If you are experiencing symptoms that might be dystonia, it is always best to discuss your concerns first with your GP and, if necessary, they will make an appropriate referral. […] They will usually refer you to a neurologist specialising in movement disorders for tests however in cases of blepharospasm you may be treated by an ophthalmologist and for laryngeal dystonia you may be seen by an ear, nose and throat (ENT) specialist. […] To make the diagnosis the neurologist will need to investigate. […] It can sometimes take a long time to get a diagnosis of dystonia. This is because symptoms of dystonia can be similar to those of other conditions, so it is often a question of ruling these out first before arriving at a diagnosis. […] Having a new diagnosis of dystonia can be a confusing and challenging time.

• #64 Dystonia Diagnosis: Clinical Neurophysiology and Genetics

  https://www.mdpi.com/2077-0383/11/14/4184

  Dystonia diagnosis is based on clinical examination performed by a neurologist with expertise in movement disorders. Clues that indicate the diagnosis of a movement disorder such as dystonia are dystonic movements, dystonic postures, and three additional physical signs (mirror dystonia, overflow dystonia, and geste antagonists/sensory tricks). […] Despite advances in research, there is no diagnostic test with a high level of accuracy for the dystonia diagnosis. Clinical neurophysiology and genetics might support the clinician in the diagnostic process. […] The neurophysiologic measure with the greatest evidence in identifying patients affected by dystonia is the somatosensory temporal discrimination threshold (STDT). […] Neurophysiology assessment is not formally included in the diagnostic process; however, neurophysiological tests can support the diagnosis.

• #65 Dystonia Diagnosis: Clinical Neurophysiology and Genetics

  https://www.mdpi.com/2077-0383/11/14/4184

  Dystonia diagnosis is based on clinical examination performed by a neurologist with expertise in movement disorders. Clues that indicate the diagnosis of a movement disorder such as dystonia are dystonic movements, dystonic postures, and three additional physical signs (mirror dystonia, overflow dystonia, and geste antagonists/sensory tricks). […] Despite advances in research, there is no diagnostic test with a high level of accuracy for the dystonia diagnosis. Clinical neurophysiology and genetics might support the clinician in the diagnostic process. […] The neurophysiologic measure with the greatest evidence in identifying patients affected by dystonia is the somatosensory temporal discrimination threshold (STDT). […] Neurophysiology assessment is not formally included in the diagnostic process; however, neurophysiological tests can support the diagnosis.

• #66 7 Everyday Questions about Cervical Dystonia – Pacific Neuroscience Institute

  https://www.pacificneuroscienceinstitute.org/blog/dystonia/7-everyday-questions-about-cervical-dystonia/

  Cervical dystonia is a painful condition that affects the neck and causes the head to tilt to one side, or causes the head to tremble. […] First off, make sure you are seen by a neurologist for a proper diagnosis. Unfortunately, cervical dystonia is very commonly misdiagnosed and patients may see five providers before getting a proper diagnosis. […] Cervical dystonia is usually lifelong, even though it does not begin until middle age (commonly). Cervical dystonia comes from the brain sending abnormal signals to the muscles, resulting in an incorrect set point. […] Many patients with cervical dystonia may experience lack of improvement or sometimes even in some cases worsening of their dystonia if they are being treated as if they had muscle spasm or degenerative disc disease. […] However, physical therapists with specialty in neurological disorders (neuro-PTs) are well versed in cervical dystonia and can definitely benefit, especially when combined with botulinum toxin injections.

• #67 Adult-Onset Idiopathic Cervical Dystonia – European Medical Journal

  https://www.emjreviews.com/neurology/article/adult-onset-idiopathic-cervical-dystonia-j190422/

  Adult-onset idiopathic focal dystonia is the most common type of primary dystonia, and adult-onset idiopathic cervical dystonia (AOICD) is its most prevalent phenotype. […] Motor symptoms at presentation are poorly recognised by non-specialists, leading to long delays in diagnosis. Certain features of history and examination can help diagnose cervical dystonia. […] Comprehensive modern management of patients with AOICD requires recognition of presence of mood disorders, and actively treating the endogenous mood disorder with antidepressant therapy. […] Cervical dystonia (CD) is the most common expression of AOIFD, characterised by sustained, involuntary contractions of the cervical neck muscles. […] Delays in diagnosis complicate research into cervical dystonia, and accurate assessment of age of onset can be difficult. This disorder is poorly recognised.

• #68 Development of a patient journey map for people living with cervical dystonia | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02270-4

  Treatment with botulinum toxin (BoNT) injections is considered first line therapy. […] The mapping process identified five key stages of the patient journey, each with specific gaps in service provision and barriers to optimal care. […] A key gap identified through stages 2 and 3 was the need for improved communication between patient and physician. Here, the mapping process clearly highlighted the need for HCPs to provide their patients with more detailed information on the disease and on the full array of treatment options, including complementary therapies such as physiotherapy and psychosocial support. […] The CDPJM identifies several common gaps in service provision. The lack of clear clinical pathways for referrals to physiotherapists and psychologists was identified as a key gap in all participating countries.

• #69 Development of a patient journey map for people living with cervical dystonia | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02270-4

  Patient journey maps are increasingly used as a tool that enables healthcare providers to refine their service provision to best meet patient needs. We developed a cervical dystonia patient journey map (CDPJM) that describes the holistic patient experience from pre-diagnosis through to long-term treatment. […] The CDPJM was developed in 2 stages; a patient survey (open questions and multichoice) of 15 patients with CD was conducted to inform the design of the CDPJM, which was then refined and validated by an expert-patient focus group. […] Qualitative analysis of the patient survey supported five key stages of the patient journey: symptom onset, diagnosis and therapeutic relationship with healthcare professionals, initiation of care for CD, start of CD treatment, and living with treated CD.

• #70 Cervical Dystonia | Parkinsons Disease and Movement Disorders Clinic

  https://www.movementdisordersclinic.com/cervical-dystonia/

  Botulinum toxin injections, commonly known by brand names such as Botox, Dysport, or Xeomin, are a primary and effective treatment for cervical dystonia. The injections work by temporarily weakening or paralyzing the overactive muscles responsible for the involuntary contractions and abnormal postures seen in cervical dystonia. […] Monitoring the effectiveness of botulinum toxin injections for cervical dystonia involves assessing changes in symptoms, improvements in functional abilities, and any side effects or adverse reactions. […] The frequency of botulinum toxin injections for cervical dystonia can vary among individuals and depends on factors such as the severity of symptoms, the specific muscles affected, and the individuals response to previous treatments. Typically, the effects of botulinum toxin injections are not permanent, and repeat injections are needed to maintain symptom relief. […] The latest breakthroughs in the field of cervical dystonia include new diagnostic and treatment approaches. Some of the most notable advancements are: Patient Journey Map, Deep Brain Stimulation (DBS), New Drugs, Focused Ultrasound, and Biomarkers for Cervical Dystonia.

• #71 Development of a patient journey map for people living with cervical dystonia | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02270-4

  Patient journey maps are increasingly used as a tool that enables healthcare providers to refine their service provision to best meet patient needs. We developed a cervical dystonia patient journey map (CDPJM) that describes the holistic patient experience from pre-diagnosis through to long-term treatment. […] The CDPJM was developed in 2 stages; a patient survey (open questions and multichoice) of 15 patients with CD was conducted to inform the design of the CDPJM, which was then refined and validated by an expert-patient focus group. […] Qualitative analysis of the patient survey supported five key stages of the patient journey: symptom onset, diagnosis and therapeutic relationship with healthcare professionals, initiation of care for CD, start of CD treatment, and living with treated CD.

• #72 Development of a patient journey map for people living with cervical dystonia | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02270-4

  Treatment with botulinum toxin (BoNT) injections is considered first line therapy. […] The mapping process identified five key stages of the patient journey, each with specific gaps in service provision and barriers to optimal care. […] A key gap identified through stages 2 and 3 was the need for improved communication between patient and physician. Here, the mapping process clearly highlighted the need for HCPs to provide their patients with more detailed information on the disease and on the full array of treatment options, including complementary therapies such as physiotherapy and psychosocial support. […] The CDPJM identifies several common gaps in service provision. The lack of clear clinical pathways for referrals to physiotherapists and psychologists was identified as a key gap in all participating countries.

• #73 Cervical Dystonia | Parkinsons Disease and Movement Disorders Clinic

  https://www.movementdisordersclinic.com/cervical-dystonia/

  Botulinum toxin injections, commonly known by brand names such as Botox, Dysport, or Xeomin, are a primary and effective treatment for cervical dystonia. The injections work by temporarily weakening or paralyzing the overactive muscles responsible for the involuntary contractions and abnormal postures seen in cervical dystonia. […] Monitoring the effectiveness of botulinum toxin injections for cervical dystonia involves assessing changes in symptoms, improvements in functional abilities, and any side effects or adverse reactions. […] The frequency of botulinum toxin injections for cervical dystonia can vary among individuals and depends on factors such as the severity of symptoms, the specific muscles affected, and the individuals response to previous treatments. Typically, the effects of botulinum toxin injections are not permanent, and repeat injections are needed to maintain symptom relief. […] The latest breakthroughs in the field of cervical dystonia include new diagnostic and treatment approaches. Some of the most notable advancements are: Patient Journey Map, Deep Brain Stimulation (DBS), New Drugs, Focused Ultrasound, and Biomarkers for Cervical Dystonia.

• #74 Dystonia Diagnosis: Clinical Neurophysiology and Genetics

  https://www.mdpi.com/2077-0383/11/14/4184

  Dystonia diagnosis is based on clinical examination performed by a neurologist with expertise in movement disorders. Clues that indicate the diagnosis of a movement disorder such as dystonia are dystonic movements, dystonic postures, and three additional physical signs (mirror dystonia, overflow dystonia, and geste antagonists/sensory tricks). […] Despite advances in research, there is no diagnostic test with a high level of accuracy for the dystonia diagnosis. Clinical neurophysiology and genetics might support the clinician in the diagnostic process. […] The neurophysiologic measure with the greatest evidence in identifying patients affected by dystonia is the somatosensory temporal discrimination threshold (STDT). […] Neurophysiology assessment is not formally included in the diagnostic process; however, neurophysiological tests can support the diagnosis.

• #75 Dystonia Diagnosis: Clinical Neurophysiology and Genetics

  https://www.mdpi.com/2077-0383/11/14/4184

  The most relevant neurophysiological feature shared by all dystonia subtypes is the reduced inhibition of central motor circuits. […] Cervical dystonia (CD) patients have abnormally increased STDT, and the effect seems higher in CD patients with tremor. […] Neurophysiology also represents an excellent support for the therapy of dystonia in the case of EMG-guided botulinum toxin injection. […] The clinical diagnosis should be based on the observations of two core characteristics and of adjunctive features. According to the EFNS dystonia guidelines, a neurophysiological test may help diagnosis despite low evidence (class IV), hence further and proper studies are needed.

• #76 Cervical Dystonia | PM&R KnowledgeNow

  https://now.aapmr.org/cervical-dystonia/

  Cervical Dystonia (CD) is an adult-onset focal dystonia presenting with pain and involuntary cranio-cervical muscle activation leading to abnormal movements or postures (often twisting nature) affecting the head, neck, and or chin. […] The reported prevalence of CD varies greatly from 2.3/100,000 to 390/100,000 with the wide ranges most likely explained by the inclusion of generalized dystonia or regional differences. […] The cause or causes of dystonia are not well established, and in many patients traditional neuroimaging studies are normal. […] Advanced In-vivo neuro imaging, such as PET or fMRI has revealed the following abnormalities in the various types of dystonias: basal ganglia volume expansion, altered dopamine D2 levels, increase in gray matter in sensory motor cortex, abnormal levels of activity in the premotor cortices, sensorimotor cortex, and supplemental motor areas during motor tasks.

• #77 Cervical Dystonia | PM&R KnowledgeNow

  https://now.aapmr.org/cervical-dystonia/

  Imaging tests are not routinely required when evaluating patients with CD as they are not useful in helping to establish the diagnosis. However, imaging (radiographs, MRI) may be useful in some patients to evaluate for conditions that may contribute to or result from constant dystonic movements. […] The treatment of choice for the vast majority of patients with CD, regardless of etiology or pattern, is injection of botulinum toxin (BoNT). […] The vast majority of patients with CD are diagnosed when the condition is chronic, not during the acute or sub-acute phase. […] It is critical that clinicians first establish the correct diagnosis including potential reversible causes.

• #78 Cervical dystonia | MedLink Neurology

  https://www.medlink.com/articles/cervical-dystonia

  Cervical dystonia is the most common form of focal dystonia. […] Diagnosis is clinical and is based on history and examination. […] An underlying cause is usually not identified, although secondary causes, especially drug-induced, should be excluded. […] The diagnosis is usually made clinically, and no confirmatory test for cervical dystonia exists. […] Excluding secondary causes is most important. […] A detailed drug history should be taken to exclude drug-induced dystonia. […] In patients with onset of illness younger than the age of 40 years, Wilson disease should be ruled out. […] One study proposed an algorithm to help diagnose cervical dystonia and better exclude mimickers. […] This algorithm achieved a 96% sensitivity and 81% specificity in diagnosis of cervical dystonia in these patients.

• #79

  https://link.springer.com/article/10.1007/s00415-023-11585-6

  The best combination of sensitivity and specificity was observed when item 6 (capability to voluntarily suppress spasms) was excluded. […] This study demonstrates two relevant points. First, an accurate diagnosis of CD is not possible if we refer only to the core clinical feature of CD as proposed in the 2013 revised classification of dystonia, i.e., patterned and repetitive movements/postures in the head/neck as well as to the combination of this item and sensory trick. Second, a higher diagnostic accuracy can be achieved if we also consider clinical features related to dystonia mimics that should be absent in dystonia. The diagnostic algorithm without the item ability to voluntarily suppress spasms was sensitive and specific enough to be proposed as a guideline for presumptive diagnosis of CD, though it needs to be further expanded and validated in a larger international sample.

• #80 Current Guidelines for Classifying and Diagnosing Cervical Dystonia: Empirical Evidence and Recommendations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8810420/

  Most investigators classified the combination of cervical and laryngeal dystonia as segmental, not focal dystonia. Although the larynx is obviously located in the neck, it has substantially different muscle control, innervation, and developmental origins. Therefore, a diagnosis of segmental dystonia seems more appropriate when there is cervical combined with laryngeal dystonia. […] A precise diagnosis is important for identifying clearly defined populations for many studies. It is important for treatment studies that involve patient-reported outcomes or quality of life for CD, because dystonia outside of the neck region may contribute to disability and therefore increase experimental variance when evaluating the effect of an intervention. A precise diagnosis is even more important for genetic studies, because a single incorrect diagnosis can dramatically alter outcomes. The results of the current study highlight several sources of inconsistency and provide recommendations to address them.

• #81 Cervical Dystonia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/25228-cervical-dystonia

  Cervical dystonia is a neurological condition (affecting your brain and nerves) that causes involuntary muscle contractions in your neck. […] A healthcare provider will diagnose cervical dystonia after a physical exam to review your symptoms. […] Testing, like an MRI or electromyography, isnt necessary unless your healthcare provider suspects spinal cord compression or nerve damage or irritation. […] Treatment for cervical dystonia may include: Botulinum toxin injections, Oral medications, Physical therapy, Deep brain stimulation surgery. […] Many people know about a common brand of botulinum toxin called Botox. This is a type of botulinum toxin serotype A that can treat cervical dystonia in addition to botulinum toxin type B. […] Your healthcare provider will inject this medication into the muscles in your neck.

• #82 Development of a patient journey map for people living with cervical dystonia | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02270-4

  Treatment with botulinum toxin (BoNT) injections is considered first line therapy. […] The mapping process identified five key stages of the patient journey, each with specific gaps in service provision and barriers to optimal care. […] A key gap identified through stages 2 and 3 was the need for improved communication between patient and physician. Here, the mapping process clearly highlighted the need for HCPs to provide their patients with more detailed information on the disease and on the full array of treatment options, including complementary therapies such as physiotherapy and psychosocial support. […] The CDPJM identifies several common gaps in service provision. The lack of clear clinical pathways for referrals to physiotherapists and psychologists was identified as a key gap in all participating countries.

• #83 Ask the MD: Cervical Dystonia | Parkinson’s Disease

  https://www.michaeljfox.org/news/ask-md-cervical-dystonia

  Doctors rely on medical history and neurological examination to make the diagnosis. There is no specific test for cervical dystonia, although blood and imaging tests are often performed to exclude other diseases that can cause similar symptoms. […] Treatment of choice for cervical dystonia is botulinum toxin injections into the overactive muscles of the neck. The effects are temporary, so injections need to be repeated every three to four months on average.

• #84 Cervical Dystonia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/25228-cervical-dystonia

  Cervical dystonia is a neurological condition (affecting your brain and nerves) that causes involuntary muscle contractions in your neck. […] A healthcare provider will diagnose cervical dystonia after a physical exam to review your symptoms. […] Testing, like an MRI or electromyography, isnt necessary unless your healthcare provider suspects spinal cord compression or nerve damage or irritation. […] Treatment for cervical dystonia may include: Botulinum toxin injections, Oral medications, Physical therapy, Deep brain stimulation surgery. […] Many people know about a common brand of botulinum toxin called Botox. This is a type of botulinum toxin serotype A that can treat cervical dystonia in addition to botulinum toxin type B. […] Your healthcare provider will inject this medication into the muscles in your neck.

• #85 Cervical Dystonia – Samir P. Macwan, MD

  https://socalmusclenerve.com/cervical-dystonia/

  Currently, there are no oral medications that are FDA approved for use in dystonia. Among the oral medications used, dopaminergic agents (levodopa), anticholinergic agents (benztropine, trihexyphenidyl), baclofen and clonazepam are the most frequently used. […] Deep brain stimulation surgery (DBS) is effective for cervical dystonia and may be appropriate for patients who lose their response to botulinum toxin, or have a form of cervical dystonia that is difficult to treat with the injections, in particular anterocollis.

• #86 Cervical Dystonia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/25228-cervical-dystonia

  Cervical dystonia is a neurological condition (affecting your brain and nerves) that causes involuntary muscle contractions in your neck. […] A healthcare provider will diagnose cervical dystonia after a physical exam to review your symptoms. […] Testing, like an MRI or electromyography, isnt necessary unless your healthcare provider suspects spinal cord compression or nerve damage or irritation. […] Treatment for cervical dystonia may include: Botulinum toxin injections, Oral medications, Physical therapy, Deep brain stimulation surgery. […] Many people know about a common brand of botulinum toxin called Botox. This is a type of botulinum toxin serotype A that can treat cervical dystonia in addition to botulinum toxin type B. […] Your healthcare provider will inject this medication into the muscles in your neck.

• #87 Dystonia: Symptoms, Causes, and Treatment Options

  https://brainfoundation.org.au/disorders/dystonia/

  For focal dystonias, including blepharospasm, spasmodic torticollis, oromandibular dystonia, spasmodic dysphonia and sometimes writers cramp, injections of botulinum toxin to temporarily weaken the muscles involved have become a very effective treatment. […] It is now being recognised that some specialised types of physiotherapy can help usually in association with botulinum toxin especially for patients with torticollis.

• #88 Cervical Dystonia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/25228-cervical-dystonia

  Cervical dystonia is a neurological condition (affecting your brain and nerves) that causes involuntary muscle contractions in your neck. […] A healthcare provider will diagnose cervical dystonia after a physical exam to review your symptoms. […] Testing, like an MRI or electromyography, isnt necessary unless your healthcare provider suspects spinal cord compression or nerve damage or irritation. […] Treatment for cervical dystonia may include: Botulinum toxin injections, Oral medications, Physical therapy, Deep brain stimulation surgery. […] Many people know about a common brand of botulinum toxin called Botox. This is a type of botulinum toxin serotype A that can treat cervical dystonia in addition to botulinum toxin type B. […] Your healthcare provider will inject this medication into the muscles in your neck.

• #89 Cervical Dystonia – Samir P. Macwan, MD

  https://socalmusclenerve.com/cervical-dystonia/

  Currently, there are no oral medications that are FDA approved for use in dystonia. Among the oral medications used, dopaminergic agents (levodopa), anticholinergic agents (benztropine, trihexyphenidyl), baclofen and clonazepam are the most frequently used. […] Deep brain stimulation surgery (DBS) is effective for cervical dystonia and may be appropriate for patients who lose their response to botulinum toxin, or have a form of cervical dystonia that is difficult to treat with the injections, in particular anterocollis.

• #90 Cervical Dystonia: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/dr/cervical-dystonia

  Cervical dystonia is a rare condition in which your neck muscles involuntarily contract into abnormal positions. […] The specific cause isnt known. […] According to a 2008 study, its important to use electrical signal diagnostics, or electromyography, to target the particular muscles for botulinum toxin injections. […] Treatment options for cervical dystonia have improved in recent years. […] When more conservative treatments dont work, surgical procedures may be an option. […] Cervical dystonia is a serious neurological disorder with no known cure as yet. […] Its likely that youll have a mix of treatments, including: botulinum toxin, physical therapy, counseling, surgery, in some cases. […] Possible complications include: the spread of involuntary motions to other parts of your body, bone spurs in the spine, cervical spine arthritis. […] People with cervical dystonia also have a higher risk of depression and anxiety.

• #91 Dystonia Diagnosis: Clinical Neurophysiology and Genetics

  https://www.mdpi.com/2077-0383/11/14/4184

  The most relevant neurophysiological feature shared by all dystonia subtypes is the reduced inhibition of central motor circuits. […] Cervical dystonia (CD) patients have abnormally increased STDT, and the effect seems higher in CD patients with tremor. […] Neurophysiology also represents an excellent support for the therapy of dystonia in the case of EMG-guided botulinum toxin injection. […] The clinical diagnosis should be based on the observations of two core characteristics and of adjunctive features. According to the EFNS dystonia guidelines, a neurophysiological test may help diagnosis despite low evidence (class IV), hence further and proper studies are needed.

• #92 Adult-Onset Idiopathic Cervical Dystonia – European Medical Journal

  https://www.emjreviews.com/neurology/article/adult-onset-idiopathic-cervical-dystonia-j190422/

  Adult-onset idiopathic focal dystonia is the most common type of primary dystonia, and adult-onset idiopathic cervical dystonia (AOICD) is its most prevalent phenotype. […] Motor symptoms at presentation are poorly recognised by non-specialists, leading to long delays in diagnosis. Certain features of history and examination can help diagnose cervical dystonia. […] Comprehensive modern management of patients with AOICD requires recognition of presence of mood disorders, and actively treating the endogenous mood disorder with antidepressant therapy. […] Cervical dystonia (CD) is the most common expression of AOIFD, characterised by sustained, involuntary contractions of the cervical neck muscles. […] Delays in diagnosis complicate research into cervical dystonia, and accurate assessment of age of onset can be difficult. This disorder is poorly recognised.

• #93 Cervical Dystonia: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/dr/cervical-dystonia

  Cervical dystonia is a rare condition in which your neck muscles involuntarily contract into abnormal positions. […] The specific cause isnt known. […] According to a 2008 study, its important to use electrical signal diagnostics, or electromyography, to target the particular muscles for botulinum toxin injections. […] Treatment options for cervical dystonia have improved in recent years. […] When more conservative treatments dont work, surgical procedures may be an option. […] Cervical dystonia is a serious neurological disorder with no known cure as yet. […] Its likely that youll have a mix of treatments, including: botulinum toxin, physical therapy, counseling, surgery, in some cases. […] Possible complications include: the spread of involuntary motions to other parts of your body, bone spurs in the spine, cervical spine arthritis. […] People with cervical dystonia also have a higher risk of depression and anxiety.

• #94 Adult-Onset Idiopathic Cervical Dystonia – European Medical Journal

  https://www.emjreviews.com/neurology/article/adult-onset-idiopathic-cervical-dystonia-j190422/

  Patients with CD frequently show an irregular, arrhythmic, spasmodic jerking movement of the head with slower recovery phases towards the neutral position. […] Specific symptoms, pain, and social anxiety associated with these should be probed in patients for targeted treatments. […] Pain is a prominent symptom and can affect the majority of patients with CD. […] Anxiety and/or depression are important features of AOIFD. […] Clinicians treating patients with AOIFD should be cognisant that dystonia is more than a motor disorder. […] Botulinum toxin (BoNT) is the most effective treatment for focal dystonias. […] With careful muscle selection and accurate injections, CD can be treated very effectively. […] A holistic approach, with multidisciplinary input, including physiotherapists, occupational therapists, and psychologists, would be most effective in improving QoL.

• #95 Development of a patient journey map for people living with cervical dystonia | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02270-4

  Treatment with botulinum toxin (BoNT) injections is considered first line therapy. […] The mapping process identified five key stages of the patient journey, each with specific gaps in service provision and barriers to optimal care. […] A key gap identified through stages 2 and 3 was the need for improved communication between patient and physician. Here, the mapping process clearly highlighted the need for HCPs to provide their patients with more detailed information on the disease and on the full array of treatment options, including complementary therapies such as physiotherapy and psychosocial support. […] The CDPJM identifies several common gaps in service provision. The lack of clear clinical pathways for referrals to physiotherapists and psychologists was identified as a key gap in all participating countries.

• #96 Cervical dystonia: Etiology, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/cervical-dystonia-etiology-clinical-features-and-diagnosis/print

  Cervical dystonia, also known as spasmodic torticollis or simply torticollis, is one of the most common adult-onset focal dystonias. […] The diagnosis is made primarily through awareness of the disorder and attention to detail during the neurologic examination. Ancillary testing is seldom necessary to establish an accurate diagnosis.

• #97 Cervical Dystonia – Brain, Spinal Cord, and Nerve Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/movement-disorders/cervical-dystonia

  Doctors base the diagnosis on symptoms and results of the physical examination. […] The diagnosis of cervical dystonia is based on symptoms and a neurologic examination.

• #98 Adult-Onset Idiopathic Cervical Dystonia – European Medical Journal

  https://www.emjreviews.com/neurology/article/adult-onset-idiopathic-cervical-dystonia-j190422/

  Adult-onset idiopathic focal dystonia is the most common type of primary dystonia, and adult-onset idiopathic cervical dystonia (AOICD) is its most prevalent phenotype. […] Motor symptoms at presentation are poorly recognised by non-specialists, leading to long delays in diagnosis. Certain features of history and examination can help diagnose cervical dystonia. […] Comprehensive modern management of patients with AOICD requires recognition of presence of mood disorders, and actively treating the endogenous mood disorder with antidepressant therapy. […] Cervical dystonia (CD) is the most common expression of AOIFD, characterised by sustained, involuntary contractions of the cervical neck muscles. […] Delays in diagnosis complicate research into cervical dystonia, and accurate assessment of age of onset can be difficult. This disorder is poorly recognised.

• #99 Diagnosis and Treatment of Cervical Dystonia: Current and Emerging Approaches

  https://www.medscape.org/viewarticle/753547

  Cervical dystonia (CD) is a potentially disabling movement disorder associated with abnormal head posture and pain, for which diagnosis is commonly either missed or delayed. […] This activity outlines diagnosis and treatment practices that clinicians can implement for a successful, long-term CD management plan. […] Optimize the timely diagnosis of CD via patient history and neurologic examination.

• #100 Comprehensive diagnosis of cervical dystonia and the efficacy of long-term (three-year) botulinum therapy | Tolmacheva | Neurology, Neuropsychiatry, Psychosomatics

  https://nnp.ima-press.net/nnp/article/view/2102

  Cervical dystonia (CD) is common in outpatient practice but in many cases is diagnosed at late stages. The efficacy of long-term botulinum therapy (BT) in CD has been poorly studied. […] The diagnosis of CD was made on average 2.31.1 years after the onset of the first symptoms, BT was started on average 52.6 years after diagnosis. At the first visit to the physician, CD was detected in only 32% of cases. […] CD is still underdiagnosed in practice, and BT is not prescribed until several years after the onset of the disease. Regular and longterm use of BT not only reduces the severity of CD, but also reduces the severity of anxiety disorders and improves patients’ quality of life.

• #101 Cervical dystonia and spasmodic torticollis treatment –

  https://caringmedical.com/prolotherapy-news/getting-help-cervical-dystonia-spastic-torticollis/

  Diagnosing the relationship between isolated head tremors and cervical dystonia. […] Identifying types of Idiopathic cervical dystonia. […] Cervical, oromandibular dystonia, and TMJ Disorders. […] The frequency and consequences of delayed Cervical dystonia diagnosis is poorly understood. […] It should be looked for more in women than men. […] It should be looked for in older patients. […] A diagnosis of Cervical dystonia was more common (or faster) when the patient had: essential tremor, cervical disc disease, neck sprain/strain, anxiety, and depression. […] This study concludes simply with: “Cervical dystonia incidence is greater in women and increases with age. Diagnostic delay is common and associated with adverse effects.” […] A November 2021 study in the medical journal Parkinsonism and Related Disorders wrote that isolated head tremor, a pathological condition characterized by head tremor without dystonic postures (tilt or twisted posture) or tremor in other body parts, has recently been suggested to be a form of dystonia. […] The researchers of this study also noted that it is still unclear whether isolated head tremor precedes dystonia or remains unmodified over time. […] The researchers concluded: “These findings will improve prognosis, treatment strategies and understanding of underlying disease mechanisms.”

• #102 Development of a patient journey map for people living with cervical dystonia | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02270-4

  Patient journey maps are increasingly used as a tool that enables healthcare providers to refine their service provision to best meet patient needs. We developed a cervical dystonia patient journey map (CDPJM) that describes the holistic patient experience from pre-diagnosis through to long-term treatment. […] The CDPJM was developed in 2 stages; a patient survey (open questions and multichoice) of 15 patients with CD was conducted to inform the design of the CDPJM, which was then refined and validated by an expert-patient focus group. […] Qualitative analysis of the patient survey supported five key stages of the patient journey: symptom onset, diagnosis and therapeutic relationship with healthcare professionals, initiation of care for CD, start of CD treatment, and living with treated CD.

• #103 Cervical Dystonia | Parkinsons Disease and Movement Disorders Clinic

  https://www.movementdisordersclinic.com/cervical-dystonia/

  Botulinum toxin injections, commonly known by brand names such as Botox, Dysport, or Xeomin, are a primary and effective treatment for cervical dystonia. The injections work by temporarily weakening or paralyzing the overactive muscles responsible for the involuntary contractions and abnormal postures seen in cervical dystonia. […] Monitoring the effectiveness of botulinum toxin injections for cervical dystonia involves assessing changes in symptoms, improvements in functional abilities, and any side effects or adverse reactions. […] The frequency of botulinum toxin injections for cervical dystonia can vary among individuals and depends on factors such as the severity of symptoms, the specific muscles affected, and the individuals response to previous treatments. Typically, the effects of botulinum toxin injections are not permanent, and repeat injections are needed to maintain symptom relief. […] The latest breakthroughs in the field of cervical dystonia include new diagnostic and treatment approaches. Some of the most notable advancements are: Patient Journey Map, Deep Brain Stimulation (DBS), New Drugs, Focused Ultrasound, and Biomarkers for Cervical Dystonia.

• #104 Cervical Dystonia: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/25228-cervical-dystonia

  With treatment, you and your healthcare provider can manage your symptoms so you can get back to the activities you enjoy without discomfort. […] No. Theres no cure for cervical dystonia. Botox, a brand of botulinum toxin, can temporarily treat the symptoms of cervical dystonia, but it isnt a cure.

• #105 Living with Cervical Dystonia: Diana’s Story | Dystonia Medical Research Foundation

  https://dystonia-foundation.org/living-with-cervical-dystonia-dianas-story/

  Cervical dystonia is a type of dystonia that affects the neck muscles, causing involuntary head and neck movement. […] It wasnt until she was 62 that a neurologist finally saw what others had missedgeneralized dystonia. After decades of uncertainty, she had a name for the invisible force controlling her body. Even then, the diagnosis would later narrow to cervical dystonia, as medical teams changed, and perspectives shifted. […] Dianas advice for other women living with cervical dystonia is simple but profound: Develop a support network. Try many of the suggestions that work for other peoplenot just once, but several times. Live life to the fullest and be thankful for everything that you can do.

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