Materiały źródłowe

• #1 Cervical dystonia: Treatment and prognosis – UpToDate

  https://www.uptodate.com/contents/cervical-dystonia-treatment-and-prognosis

  Cervical dystonia, also known as spasmodic torticollis or simply torticollis, is one of the most common adult-onset focal dystonias. It is a hyperkinetic movement disorder that manifests with varying degrees of abnormal neck posturing, neck tremor, and/or neck pain. Although generally benign, cervical dystonia can lead to significant disability if untreated, and it is often underrecognized and misdiagnosed. […] The treatment of choice for cervical dystonia is botulinum toxin (BoNT) injections, which are administered into target neck muscles to cause selective denervation and relaxation of the abnormal neck posture. Oral medications are useful adjuncts in some patients, but side effects are often limiting and antidystonia effects are relatively modest. Surgical therapy with deep brain stimulation (DBS) is available for refractory cases.

• #2 Cervical dystonia – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cervical-dystonia/diagnosis-treatment/drc-20354128

  There is no cure for cervical dystonia. In some people, signs and symptoms may disappear without treatment, but recurrence is common. Treatment focuses on relieving the signs and symptoms. […] Botulinum toxin, a paralyzing agent often used to smooth facial wrinkles, can be injected directly into the neck muscles affected by cervical dystonia. Examples of botulinum toxin drugs include Botox, Dysport, Xeomin and Myobloc. […] Most people with cervical dystonia see an improvement with these injections, which usually must be repeated every three to four months. […] To improve results or to help reduce the dosage and frequency of botulinum toxin injections, your doctor might also suggest oral medications that have a muscle-relaxing effect. […] Sensory tricks, such as touching the opposite side of your face or the back of your head, may cause spasms to stop temporarily. Different sensory tricks work for different people, but they often lose effectiveness as the disease progresses.

• #2 Cervical dystonia – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cervical-dystonia/diagnosis-treatment/drc-20354128

  Heat packs and massage can help relax your neck and shoulder muscles. Exercises that improve neck strength and flexibility also may be helpful. […] If less invasive treatments don’t help, your doctor might suggest surgery. Procedures may include: Deep brain stimulation. In this procedure, a thin wire is guided into the brain through a small hole cut into the skull. The tip of the wire is placed in the portion of the brain that controls movement. Electrical pulses are sent through the wire to interrupt the nerve signals making your head twist. […] Another option is to surgically sever the nerves carrying the contraction signals to the affected muscles.

• #3 Cervical Dystonia: Diagnosis and Treatment | Columbus, OH

  https://orthoneuro.com/neurology/cervical-dystonia/

  Cervical dystonia can be genetic but you can develop the issue without a family history of the disease. The primary risk factors for cervical dystonia are your age, gender, and family history. In some cases, this can be associated with trauma. […] While theres no cure for cervical dystonia, your neurologist at OrthoNeuro can provide treatments to relieve muscle spasms, pain, and tremors. […] Depending on your needs, your doctor may recommend any of the following therapies: Non-surgical options typically include the following: Activity modification, Bracing, Non-steroidal anti-inflammatory drugs (NSAIDs), Corticosteroid injections. […] Your physician may prescribe medications to relax your muscles and relieve spasms or tremors. Some of the drugs used to treat dystonia include: Muscle relaxants, Anti-seizure medications, Anti-depressant medications.

• #4 Cervical dystonia: Treatment and prognosis – UpToDate

  https://www.uptodate.com/contents/cervical-dystonia-treatment-and-prognosis

  Treatment of cervical dystonia is symptomatic and optional. The goals of therapy are to improve neck alignment and cosmetic appearance, reduce pain and other secondary complications, and minimize treatment-related side effects. […] Treatment options include botulinum toxin (BoNT) injections, oral medications, and deep brain stimulation (DBS) for refractory cases. Among these, BoNT injections are the most effective and well-tolerated treatment. Oral medications have more modest effects on dystonia and are used primarily as add-on therapy or when BoNT is not practical or desired.

• #5

  https://practicalneurology.com/diseases-diagnoses/movement-disorders/movement-disorders-moment-treatment-approaches-to-cervical-dystonia/31720/

  Botulinum toxins are effective treatment. […] Botulinum neurotoxins are the only treatment for CD approved by the Food and Drug Administration (FDA) and are the treatment of choice, although multiple oral medications are also used frequently. […] Approximately 50%-90% of patients experience improvements in dystonic symptoms and dystonia-related pain with botulinum toxin. […] Approximately 70% of patients report pain relief after 3 treatments with botulinum toxin injections with a mean time to pain relief close to 7 days, although level of pain relief achieved depends on the initial pain level. […] Botulinum toxin acts on CD by reducing excessive tone through acetylcholine inhibition to alleviate painful muscle spasms. […] Deep brain stimulation (DBS) of the globus pallidus internus (GPi) may be an effective treatment for CD.

• #6

  https://practicalneurology.com/articles/2020-oct/movement-disorders-moment-treatment-approaches-to-cervical-dystonia

  Botulinum toxins are effective treatment. […] Botulinum neurotoxins are the only treatment for CD approved by the Food and Drug Administration (FDA) and are the treatment of choice, although multiple oral medications are also used frequently. […] Approximately 50%-90% of patients experience improvements in dystonic symptoms and dystonia-related pain with botulinum toxin. […] Approximately 70% of patients report pain relief after 3 treatments with botulinum toxin injections with a mean time to pain relief close to 7 days, although level of pain relief achieved depends on the initial pain level. […] The therapeutic approach to adjunctive treatment of pain in CD should be tailored to individual needs. […] Deep brain stimulation (DBS) of the globus pallidus internus (GPi) may be an effective treatment for CD.

• #7 About Cervical Dystonia & Treatment Options | MYOBLOC

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

  There are 2 types of botulinum toxin used to help treat cervical dystonia. Both block acetylcholine in different ways. MYOBLOC is a type B toxin that is administered right in your healthcare providers office and treatment takes only a few minutes. […] MYOBLOC disables a protein that would typically trigger the release of excessive acetylcholine, which causes muscles to become tense and spasm. […] When your healthcare provider injects MYOBLOC into affected muscles, it blocks the release of acetylcholine, allowing them to relax. […] Over time, your healthcare provider will adjust the dose of MYOBLOC to achieve maximum pain relief and muscle spasm control. […] The most common side effects of MYOBLOC in people with cervical dystonia include dry mouth, trouble swallowing (dysphagia), injection site discomfort or pain, and headache.

• #8 Pain and Quality of Life in the Treatment of Cervical Dystonia – touchNEUROLOGY

  https://touchneurology.com/movement-disorders/journal-articles/pain-and-quality-of-life-in-the-treatment-of-cervical-dystonia/

  Currently, there are two serotypes of BoNT (BoNT type A [BoNTA] and BoNT type B [BoNTB]), and four brands are now approved for the treatment of CD: three BoNTA preparations Botox (Allergan, US), Dysport (Ipsen, UK) and Xeomin (Merz, Germany) and one BoNTB preparation Myobloc/ Neurobloc (Solstice Neurosciences, US). […] Regarding the control of pain in CD, a systematic review found that in five trials in which patients were assessed for pain relief using an analogue scale, the injection of BoNTA markedly improved pain (odds ratio [OR] 11.9, 95% CI 6.322.5). […] Although CD has a marked impact on quality of life, no RCT has assessed QoL as a primary outcome. […] Data on the effect of BoNT in the QoL of patients with CD are derived solely from five case series using BoNTA. […] They all consistently report a moderate to marked improvement in QoL, a benefit that does not correlate with the change in objective clinical severity scales, suggesting that the effectiveness of BoNT is better captured by subjective than objective scales.

• #8 Pain and Quality of Life in the Treatment of Cervical Dystonia – touchNEUROLOGY

  https://touchneurology.com/movement-disorders/journal-articles/pain-and-quality-of-life-in-the-treatment-of-cervical-dystonia/

  Cervical dystonia (CD) is a chronic movement disorder characterised by abnormal postures of the neck. […] However, the available data suggest that therapeutic interventions that improve dystonia also alleviate pain and have a beneficial effect on QoL. The management of CD should incorporate problems such as pain, depression and anxiety in order to achieve a significant decrease in the burden of disease. […] Currently, CD is an incurable disease. Available symptomatic interventions should aim not only at the relief of dystonia and the associated symptoms, but also to decrease functional disability and improve QoL. […] Therapeutic interventions for CD are broadly divided into botulinum toxin (BoNT), oral drugs, surgical interventions and physical therapy. […] BoNT is well-established as an effective and safe treatment for CD, as supported by seven class I studies.

• #9 Adding a New Treatment Option to Cervical Dystonia With DaxibotulinumtoxinA

  https://www.neurologylive.com/view/adding-new-treatment-option-cervical-dystonia-daxibotulinumtoxina

  Cervical dystonia has been traditionally treated with boluinumtoxin drugs, including Botox, Dysport, Xeomin, and Myobloc. The toolbox recently expanded with the FDA approval of Revances daxibotulinumtoxinA-Ianm (Daxxify), the first and only peptide-formulated long-lasting neuromodulator to treat the condition. […] In ASPEN-1 both the 125- and 250-unit dose groups of daxibotulinumtoxinA met the primary end point of clinically meaningful improvement in the signs and symptoms of cervical dystonia, on average, by weeks 4 and 6. […] This provides another tool in our treatment toolbox and potentially allows for a longer acting botulinum toxin to be used in certain patients. […] Yes, certain patients are more appropriate for this treatment because of factors to do with their condition where their current treatment is not lasting for the full 12 weeks, the time point they can receive another treatment with current label indication and insurance coverage for the other botulinum toxins in the market.

• #10 Botulinum Toxin Therapy for Cervical Dystonia: The Science of Dosing | Tremor and Other Hyperkinetic Movements

  https://tremorjournal.org/articles/10.5334/tohm.185

  However, few data on optimal use of BoNT for CD or expert consensus recommendations are available to guide physicians in consideration of these factors. […] Therefore, important questions remain regarding various aspects of the optimal clinical application of BoNT for CD. […] In general, expert reviews of BoNT treatment for CD recommend using the lowest effective dose at the longest dosing interval that effectiveness can be maintained, which is widely considered to be about 12 weeks for most patients. […] The labeling for onabotulinumtoxinA recommends a total dose not to exceed 360U administered every 12-16 weeks or at longer intervals, with dosing tailored to the individual patient based on head and neck position, localization of pain, muscle hypertrophy, patient response, and AE history.

• #11 Daxxify Approved for Cervical Dystonia Treatment – MPR

  https://www.empr.com/home/news/daxxify-approved-for-cervical-dystonia-treatment/

  Daxxify is supplied as a lyophilized powder for reconstitution in single-dose 50 Unit and 100 Unit vials. […] The Food and Drug Administration (FDA) has approved Daxxify (daxibotulinumtoxinA- lanm) for the treatment of cervical dystonia in adults. […] The recommended dose for cervical dystonia ranges from 125 Units to 250 Units. Treatment is administered intramuscularly as a divided dose among affected muscles.

• #12 Botulinum Toxin Therapy for Cervical Dystonia: The Science of Dosing | Tremor and Other Hyperkinetic Movements

  https://tremorjournal.org/articles/10.5334/tohm.185

  The product labeling for abobotulinumtoxinA recommends an initial dose of 500U, with repeat doses of 250U to 1000U as needed, at intervals of 12-16 weeks or longer as necessary, based on return of clinical symptoms. […] The PI document for incobotulinumtoxinA recommends an initial dose of 120U, with frequency of subsequent injections to be determined by clinical response but should generally be no more frequent than every 12 weeks. […] In summary, the generally recommended minimum interval between repeat BoNT-A injections provided in product PIs is about 12 weeks. […] Although the application of BoNT-A treatment for CD is a complex and challenging procedure, there are few expert recommendations and supporting clinical data to guide clinicians in optimizing this therapy.

• #13 Cervical Dystonia – Dosing and Administration | BOTOX ONE® | BOTOX® (onabotulinumtoxinA)

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

  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%).

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

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

  Cervical dystonia is a type of focal dystonia. This is a group of conditions that cause muscle spasms in one part of your body. […] 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. Botulinum toxin works by weakening the dystonic neck muscle, in turn, keeping it from contracting. […] Some of the most common medications to treat cervical dystonia include: Dopaminergic agents (levodopa), Anticholinergic agents (benztropine, trihexyphenidyl), Baclofen, Clonazepam. […] 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.

• #15 Treatment Guidelines | Dystonia Coalition

  https://dc.rarediseasesnetwork.org/treatment-guidelines

  Trihexyphenidyl and related anti-cholinergics (benztropine, biperidin, procyclidine, scopolamine) block muscarinic acetylcholine receptors. The anticholinergics are among the most widely prescribed oral agents for all types of dystonia. However, efficacy is limited and side effects are common because high doses are required. Levodopa is a precursor in dopamine synthesis and serves to augment dopamine levels. Its mechanism is thought to involve augmentation of dopaminergic neurotransmission in the basal ganglia. In children with dopa-responsive dystonia, the combination of levodopa with carbidopa is remarkably effective with almost complete elimination of symptoms at low doses. Tetrabenazine depletes neuronal dopamine stores by displacing it from storage vesicles. It is FDA-approved for the treatment of chorea in Huntington’s disease, but it appears capable of suppressing a variety of hyperkinetic movements.

• #16 Treatment Guidelines | Dystonia Coalition

  https://dc.rarediseasesnetwork.org/treatment-guidelines

  BTX therapy has been the focus of several lengthy reviews and prior educational programs and workshops at the AAN, so this summary addresses only the key aspects. For many dystonias, therapy with BTX is highly effective and the treatment of choice. Typical success rates are 80-90% for focal craniofacial and cervical dystonias, but lower for oromandibular and limb dystonias. The most important factor determining success with BTX is proper selection of muscles for treatment and proper selection of doses for each muscle. […] For cervical dystonia, the initial choice for an adjunctive oral agent often is trihexyphenidyl. BTX alone, or combined with one adjunctive oral agent, suffices for the vast majority of patients. If combined treatment is inadequate or resistance to BTX develops, selective denervation or DBS can be considered. For patients with generalized dystonia, it is not feasible to target all involved body regions with BTX. Instead, the primary treatment modality involves oral medications.

• #17 Cervical Dystonia – Dystonia Ireland

  https://www.dystonia.ie/forms-of-dystonia/focal-forms/cervical-dystonia/

  Surgery may be considered when patients are no longer receptive to other treatments, including botulinum toxin injections and medications. Selective denervation surgery is an option for some cervical dystonia patients, and deep brain stimulation surgery is beginning to be explored for cervical dystonia as well. […] Physiotherapy may be helpful in the treatment of cervical dystonia. The goals of physiotherapy for people with cervical dystonia are to help increase range of motion, to increase flexibility, to correct muscle imbalances, to improve posture, to increase balance, to enhance functional abilities in home and workplace, and to improve coordination.

• #18 Patient considerations in the treatment of cervical dystonia: focus on botulinum toxin type A

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4459632/

  In a review of the effectiveness of physiotherapy alone or added on to BoNT injections for CD, there is evidence to suggest that a multimodal physiotherapy program in addition to BoNT therapy may improve head position, decrease pain levels, and improve functioning in everyday activities for the short term. […] BoNT is considered the treatment of choice for CD. There are three BoNT type A formulations that are currently approved and each has its own unique pharmacologic properties that may confer different side effect profiles, duration of therapeutic effects, and dosing recommendations.

• #19 Living with Cervical Dystonia – Neurology One

  https://neurologyone.com/cervical-dystonia-2/

  Cervical dystonia has no cure, but botulinum toxin injections can reduce symptoms for some individuals. Sustained remissions are rare, and surgery may be an option for a few cases. […] In Orlando, Neurology One provides extensive care to patients with Cervical dystonia. The treatment for cervical dystonia has advanced in recent times. Physical therapy and counseling, specifically for stress management, can also aid in managing symptoms. […] Physical therapy benefits cervical dystonia patients, including massage, heat therapy, targeted stretching, and strengthening exercises. […] A 2012 study of 20 individuals with cervical dystonia in Brazil showed improvement in pain, symptoms, and quality of life with physical therapy. […] Biofeedback uses electronic instruments to monitor muscle activity, blood flow, and brain waves. This provides this information to aid in managing involuntary motions in cervical dystonia patients.

• #20 Physical therapy program for cervical dystonia: a study of 20 cases

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3812762/

  Botulinum toxin (BTX) is the best therapeutic option in patients with cervical dystonia (CD), but physical therapy (PT) can be added to the treatment to achieve better results. […] An analysis of the physical aspects of SF-36 showed significant improvement in G1 on three subscales. […] BTX plus PT treatment achieved symptom relief in patients with CD and improved their quality of life. […] However, some authors recommend a multidisciplinary approach to CD including physical therapy (PT) for better results. […] Given the scarcity of studies on CD treatment investigating the association between BTX and PT, we developed a new rehabilitation protocol, which consisted of three approaches: kinesiotherapy, motor learning exercises, and functional electrical stimulation (FES). […] The proposed PT protocol including kinesiotherapy and tissue release techniques may help improve these patients QoL. […] This study suggests that the combination of BTX injections and a PT program including kinesiotherapy, motor learning exercises, and muscle strengthening techniques, may improve disease severity, disability, pain, and QoL in patients with CD.

• #21 Cervical Dystonia and Direct Current Treatment »

  https://onetherapy.com/cervical-dystonia-and-neubiedirect-current-treatment/

  Discover how Neubie technology aids Cervical Dystonia by stimulating inhibited areas, leading to improved breathing, enhanced mobility, better sleep, and an overall sense of well-being. […] Multiple systematic reviews have shown that physical therapy in conjunction with medical intervention including botox injections can have positive impacts on patients with cervical dystonia. […] Physical therapy offers a wide variety of treatments for patients with cervical dystonia, including but not limited to dry needling, soft tissue mobilization, joint mobilization, Redcord Suspension Training, improving breathing mechanics, relaxation/meditation techniques, nutritional assessment, and new technology utilizing direct current to create changes in the body. […] The Neubie positively affects the neuromuscular system, not just your muscles. It helps provide the right kind of sensory input to stimulate changes in your motor system, stimulating areas that are inhibited and calming areas that are too tense. The changes can help you breathe better, feel better, move better, sleep better, and overall have more energy. You will notice an improvement in your range of motion, pain, strength, and motor control.

• #22 Effective Exercises for Cervical Dystonia Management

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

  In most cases, the best exercises for torticollis include stretching. Sometimes you can add a range of motion exercises to it. You should perform the stretch slowly and carefully. Excessive force may cause more pain or discomfort. […] Regular physical therapy for spastic torticollis can help reduce pain. You can improve mobility in your neck, shoulders, and back. With time and diligence, you can manage your symptoms more effectively. […] You can manage cervical dystonia through medical treatment, physical therapy, and lifestyle modifications. Medications such as Botox injections may help reduce spasms, while physical therapy exercises can help strengthen the neck muscles and improve flexibility. […] It is recommended to exercise for at least 20 minutes every day. Start slow and gradually increase the intensity as your neck muscles strengthen. Remember to take regular breaks between exercises and to stop if it causes pain.

• #23 Cervical Dystonia Treatment Options Explored

  https://drchandrilchugh.com/cervical-dystonia/cervical-dystonia-treatment-options-explored/

  In cases where less invasive treatments do not provide sufficient relief, surgery may be considered as an option for cervical dystonia treatment. Surgical treatments for cervical dystonia include deep brain stimulation (DBS) and nerve cutting. […] Both deep brain stimulation and nerve cutting should be thoroughly discussed with a specialist to evaluate their potential benefits and risks. […] As the field of medicine continues to advance, new treatments for cervical dystonia are being explored through clinical trials. […] The treatment options for cervical dystonia include medications, therapies, surgical procedures, participation in clinical trials, and lifestyle modifications. […] Sensory tricks, heat packs and massage, and exercises that improve neck strength and flexibility can be beneficial in managing the symptoms of cervical dystonia.

• #24 Dystonia Treatment | Dystonia | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/dystonia/dystonia-treatment/

  Deep brain stimulation (DBS): During this procedure, a neurosurgeon implants electrodes into a specific part of the brain. The electrodes are connected to a generator implanted in the chest near the collarbone that sends electrical pulses to the brain. DBS can reduce dystonia symptoms by 25 to 80 percent, especially in people for whom medical therapy has been unsuccessful. […] Many forms of dystonia affect mobility, posture, balance, stamina, and the ability to complete everyday tasks. Physical therapy can help improve flexibility and strengthen weakened muscles. […] Spasmodic dystonia or voice dystonia can cause involuntary spasms in the throat muscles that are responsible for speech, resulting in a change in vocal quality. People with these types of dystonia might benefit from speech therapy.

• #25 Dystonia Diagnosis and Treatment | Froedtert & MCW

  https://www.froedtert.com/parkinsons-movement-disorders/tremors/dystonia

  Cervical dystonia (spasmodic torticollis): dystonia that affects the neck and sometimes shoulders. Muscles in the neck that control the position of the head are affected, causing the head to twist and turn to one side and possibly pull forward or backward. Most people first experience symptoms in middle age. More information is available online from the National Spasmodic Torticollis Association. […] As with most treatment plans, we start with medication to treat dystonia. […] If your dystonia does not adequately respond to medication, we will consider deep brain stimulation (DBS). You may have dramatic improvement in your symptoms while reducing your medications. We evaluate each patient relative to their lifestyle and treatment goals to determine if DBS is an option. […] General qualifications for dystonia treatment with DBS include: Symptoms for at least three years, Symptoms not adequately controlled with medications, No significant problems with thinking and memory.

• #26 Cervical Dystonia |

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

  Selective peripheral denervation is a procedure used only for treatment of CD. The treatment involves cutting the specific nerves that innervate the neck muscles affected in each case. […] Studies of DBS targeting the globus pallidus (in the middle of the brain) in refractory CD have provided positive results. […] Physical therapists will teach how to perform daily tasks in a way that minimises pain. […] Stress exacerbates the symptoms of CD so learning to manage your stress levels may be an effective way that you can control your condition.

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

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

  Treatment can include physical therapy, medications, and selective denervation of neck muscles with surgery or locally injected botulinum toxin. […] Spasms can sometimes be temporarily inhibited by physical therapy and massage, including sensory biofeedback techniques (eg, slight tactile pressure to the jaw on the same or other side as head rotation) and any light touch. […] Injections of botulinum toxin type A or B into the dystonic muscles can reduce painful spasms for 1 to 4 months in about 70% of patients, restoring a more neutral position of the head. […] Oral medications can usually relieve pain, but they suppress dystonic movements in only about 25 to 33% of patients. […] Surgical procedures involving areas outside the brain are controversial; an example is a procedure that selectively severs nerves to affected neck muscles, permanently weakening or paralyzing them.

• #28 Cervical dystonia and spasmodic torticollis treatment –

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

  Botox injections are not disease altering – they do not fix what is causing the muscle spasms. […] The most common reason for discontinuing therapy is the lack of benefit. […] Cervical Fusion Surgery […] Patients that are not responding to conservative medical treatment may be potential surgical candidates. […] Surgical interventions can result in a long-term improvement in abnormal dystonic activity. […] Prolotherapy is a nonsurgical regenerative injection technique that introduces small amounts of an irritant solution to the site of painful and degenerated tendon insertions, joints, ligaments, and in adjacent joint spaces during several treatment sessions to promote growth of normal cells and tissues. […] The difference between Botox injections and Prolotherapy injections is that Prolotherapy addresses why neck muscle spasms.

• #29 Vibro-Tactile Stimulation to Treat Cervical Dystonia | Human Sensorimotor Control Lab

  https://hsc.umn.edu/vibro-tactile-stimulation-topic/vibro-tactile-stimulation

  Cervical Dystonia (CD) is a neurological movement disorder that is characterized by abnormal head movements or postures caused by involuntary contractions of neck muscles. There is no cure for CD. Current treatment opportunities for CD are limited and consist mainly of injections of Botulinum toxin (Botox) a neurotoxin injected in the dystonic muscles. However, this treatment provides only temporary relief and has to be repeated in regular intervals (approximately every 8-12 weeks). […] The aim of this project is to explore vibro-tactile stimulation of neck muscles as a non-invasive, non-pharmacological treatment method for individuals with CD, who do not tolerate the Botox or who want to seek an adjuvant method after injection of the Botox. […] Vibro-tactile stimulation (VTS) is a non-invasive neuromodulation technique that our laboratory developed for people with CD. […] We are currently conducting a larger multi-center clinical trial to determine the effects of VTS on alleviating abnormal cervical muscle contractions in patients with CD. […] Results from our multi-center clinical trial indicate that cervical VTS can reduce neck pain that is associated with CD.

• #30 Dystonia – Focused Ultrasound Foundation

  https://www.fusfoundation.org/diseases-and-conditions/dystonia/

  Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with dystonia. […] Focused ultrasound treatment for dystonia is not yet approved by regulatory bodies or covered by medical insurance companies. […] A clinical trial in Japan has begun treating patients with cervical dystonia has been completed. […] The primary options for treatment of dystonia include medications and invasive surgery. However, medications work temporarily, whereas focused ultrasound will offer a more durable treatment that may be permanent. […] For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications such as surgical wound healing or infection at a lower cost. If needed, focused ultrasound can also be repeated. […] Horisawa S, Saito R, Qian B, Hori H, Kim K, Murakami M, Kakegawa T, Abe K, Fukui A, Kohara K, Iijima M, Kawamata T, Taira T. Focused Ultrasound Pallidothalamic Tractotomy in Cervical Dystonia: A Pilot Study. Mov Disord. 2024 Nov 2. doi: 10.1002/mds.30030. PMID: 39487633.

• #31 Clinical Trial of Focused Ultrasound for Cervical Dystonia Begins – Focused Ultrasound Foundation

  https://www.fusfoundation.org/posts/clinical-trial-of-focused-ultrasound-for-cervical-dystonia-begins/

  The first patient has been treated in a clinical trial in Tokyo that is using focused ultrasound to address cervical dystonia. […] The first patient has been treated in a new Foundation-funded clinical trial in Tokyo using focused ultrasound to treat patients with cervical dystonia. […] The trial will evaluate the safety and initial effectiveness of using Insightecs Exablate Neuro focused ultrasound device to create a pallidothalamic tractotomy, which interrupts the brain signals believed to be responsible for cervical dystonia.

• #32 New Treatment for Cervical Dystonia: A New Approach in Neuroplastic Training – Dystonia Recovery Program

  https://dystoniarecoveryprogram.com/new-treatment-for-cervical-dystonia/

  Explore a new approach to treating cervical dystonia with Dr. Farias Neuroplastic Training. This method focuses on the brain’s ability to reorganize itself, aiming to improve movement coordination. […] His method, known as Neuroplastic Training and Neuroplastic Movement Therapy, explores the brains capacity for neuroplasticity, offering a novel perspective on addressing the underlying mechanisms of dystonia. […] Dr. Farias approach focuses on retraining the brain to remember and reinstate proper movement patterns. The therapy involves exercises that encourage the brain to replace faulty movement patterns with functional ones, thus promoting recovery of motor function. […] A significant aspect of Dr. Farias work involves identifying and managing the involuntary muscle tensions that contribute to dystonia.

• #33 New Treatment for Cervical Dystonia: A New Approach in Neuroplastic Training – Dystonia Recovery Program

  https://dystoniarecoveryprogram.com/new-treatment-for-cervical-dystonia/

  Post-training fMRI scans often reveal significant improvements. The previously overactive areas show normalized activity, while under-active regions re-engage, leading to better coordination. […] These brain changes highlight the potential of Neuroplastic Training to induce meaningful recovery by realigning the brains activity patterns, offering a new perspective in managing cervical dystonia and other forms of Dystonia such as Blepharospasm, Hand Dystonia, Leg Dystonia, Facial Dystonia and Oromandibular Dystonia. […] Dr. Farias Neuroplastic Training and Neuroplastic Movement Therapy offer a new perspective on the treatment of cervical dystonia. This approach focuses on the brains natural ability to adapt and reorganise, aiming to address the underlying causes of dystonia rather than merely managing symptoms.

• #34 A Neurological Physical Therapist’s Guide to Treating Cervical Dystoni

  https://www.reactivept.com/single-post/2019/03/16/a-neurological-physical-therapists-guide-to-treating-cervical-dystonia

  A holistic and team-based approach is essential for success in the treatment of CD. […] First, it is super important to note that treatment in dystonia is not done in a PT bubbleit is necessary to have a holistic team approach! […] A recent systematic review (De Pauw et al 2014) found 16 studies of physical therapy with the majority having low methodological quality including small sample sizes, lack of randomization or blinding and variety of treatment techniques and outcome measures. […] In our experience, there are pieces of all of these interventions that have been helpful with our clients, but each person needs an individualized approach. […] We have based the framework for our approach off of a key piece of literature in the dystonia worldbut it is for focal dystonia. […] The principles presented in the learning based sensorimotor training (LBSMT) (Byl, Archer, McKenzie, 2008) for focal dystonia have been invaluable in shaping our treatment approach. […] We have found success with this systematic approach at re+active and know that you will, too. […] A multi-disciplinary an holistic approach […] Apply learning based sensorimotor re-training including […] Brain set up […] Brain work […] Treat underlying factors.

• #35 Naturally Curious: An Integrative Approach to Treating Dystonia | Dystonia Medical Research Foundation

  https://dystonia-foundation.org/integrative-treatment/

  Living well with dystonia often requires a combination of treatment approaches. Available medical therapies such as oral medications, botulinum neurotoxin injections, and surgical interventions may be more effective for some people than others. […] Dr. Bega often finds himself in conversation with patients about complementary therapies, which are among his research interests. […] Sarah Roers is among those who use a combination of therapeutic approaches. She was diagnosed with cervical dystonia about a year and a half ago. Acupuncture, chiropractor, massage, tens unit, yoga, and especially Pilates help me with my CD. I also get botulinum neurotoxin injections every three months, she said. […] A man with cervical dystonia whom Dr. Bega was treating with botulinum neurotoxin reported that the injections helped quite a bit, but repeatedly mentioned that acupuncture was making the biggest difference for him.

• #36 Natural Treatments for Cervical Dystonia – Dystonia Recovery Program

  https://dystoniarecoveryprogram.com/cervical-dystonia-treatment-natural/

  Cervical Dystonia, marked by involuntary muscle contractions in the neck, prompts individuals to explore alternative treatments for enhanced relief. […] Acupuncture, a cornerstone of traditional Chinese medicine, involves inserting needles into specific body points. Individuals with Cervical Dystonia have reported benefits, including improved muscle relaxation and pain reduction, after acupuncture sessions. […] Tailored physical therapy for Dystonia aims to enhance posture, strengthen muscles, and improve flexibility. Exercises and relaxation techniques administered by physical therapists contribute to overall symptom management in Cervical Dystonia. […] Tai Chi, an ancient Chinese martial art such as Shaolin KungFu, combines gentle movements and deep breathing. This practice fosters balance, flexibility, and relaxation, potentially benefiting individuals with Cervical Dystonia in managing symptoms and promoting overall well-being.

• #37 Post-Traumatic Cervical Dystonia: What It Is & How to Treat It

  https://www.flintrehab.com/post-traumatic-cervical-dystonia/?srsltid=AfmBOorhYMWPBeuLqlwNWf7SsiLjAVuzl4V0PJ7bYgz2ukR-JmtLUpC3

  The only way to fully treat post-traumatic cervical dystonia is to address the root cause, which is poor communication between the brain and the neck muscles. […] Physical therapy may help relieve cervical dystonia by activating the brains neuroplasticity. […] Deep brain stimulation is a surgical treatment for dystonia that uses implanted electrodes to send high-frequency signals to areas of the brain that control involuntary movements. […] Combining physical therapy with anti-spasmodic medication seems to be the most effective treatment approach. Other therapies such as acupuncture and deep brain stimulation may also reduce symptoms.

• #38 Pain and Quality of Life in the Treatment of Cervical Dystonia – touchNEUROLOGY

  https://touchneurology.com/movement-disorders/journal-articles/pain-and-quality-of-life-in-the-treatment-of-cervical-dystonia/

  Several oral drugs have been reported to be efficacious for the treatment of CD, such as anticholinergics, antidopaminergics, dopaminergics, GABAergics, benzodiazepines and antiepileptics. […] Peripheral surgical techniques, either selective peripheral denervation or myectomy, have been reported to be efficacious for the treatment of patients with CD refractory to BoNT. […] Deep brain stimulation (DBS) is largely replacing ablative surgery for dystonia, particularly DBS of the globus pallidus internus (DBS-GPi). […] Several rehabilitation techniques for the treatment of CD have been reported, but the data are generally of poor methodological quality. […] The main determinants for a poor QoL are depression, anxiety and pain. […] Although there are no specific trials that have evaluated the effect of pharmacological, surgical or physical treatments on pain or QoL as primary outcomes, the best data available suggest that all interventions that have improved dystonia have also alleviated pain and improved QoL domains. […] The therapeutic strategy to manage CD likely requires multiple pharmacological/ surgical interventions to target dystonia, pain, depression and anxiety in order to achieve a major decrease in the burden of disease.

• #39 Impact of Physiotherapy in the Treatment of Pain in Cervical Dystonia | Tremor and Other Hyperkinetic Movements

  https://tremorjournal.org/articles/10.5334/tohm.867

  Almost all patients (n = 89/91) indicated a noticeable benefit in pain with an average improvement of 51% (SD 23%) when receiving PT. […] Our study illustrates the high frequency of physiotherapy and other adjunctive therapies in addition to BoNT treatment in a real-life cohort of patients with cervical dystonia. We were able to highlight the importance of PT to reduce pain associated with CD, which significantly affects quality of life. Although, PT is not an evidence-based treatment option in CD our results suggest that PT should be prescribed on a regular basis in addition to BoNT.

• #40 Cervical Dystonia: Diagnosis & Treatment Options

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

  After a diagnosis of cervical dystonia, the doctor can recommend appropriate treatment options. Several medications are available to treat cervical dystonia, including muscle relaxants, antispasmodics, and anticonvulsants. But there are other treatment options as well. […] Physical therapy is another effective therapy option for cervical dystonia. The physical therapist can work on stretching and strengthening the neck muscles. This way, they will relieve pain and improve mobility. […] In some cases of severe cervical dystonia, surgery may be necessary. You may need surgery to release spastic muscles or stabilize your spine. Your doctor will determine if you need surgery or not. […] Exercise for cervical dystonia can help manage symptoms and reduce neck pain. Gentle neck stretches, shoulder rotations, and neck rotations can help keep your neck muscles flexible and maintain a healthy posture. […] Treatment usually includes medication, physical therapy, and in some cases, surgery. With the correct diagnosis and treatment plan, most people with neck dystonia can lead relatively everyday lives.

• #41 Cervical Dystonia: Symptoms, Causes And Treatment | Headache, Migraine & Concussion Center

  https://hmccentre.com/cervical-dystonia-symptoms-causes-and-treatment/

  If less invasive treatment is not effective, surgical procedures can be used to treat cervical dystonia as well. Deep brain stimulation is a surgical procedure where a thin wire is inserted into the brain and placed in the region of the brain that controls movement. […] Individuals affected by cervical dystonia also may be at increased risk for depression and anxiety. Therefore, addressing any emotional and mental health issues can play an important role in the treatment of this condition.

• #42 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. Theres no cure as yet, but symptoms can be treated. […] The primary treatment for pain relief is botulinum toxin injections in the neck muscles every 11 to 12 weeks. This immobilizes the nerves in the neck muscles. Its reported to relieve pain and other symptoms in 75 percent of people with cervical dystonia. […] Several types of oral medications are reported by the Dystonia Foundation to help relieve the symptoms associated with cervical dystonia. […] Treatment options for cervical dystonia have improved in recent years. In addition to physical treatment, counseling may be helpful, especially in methods to help you cope with stress. […] Physical therapy may help. This includes massage and heat to relax your neck and shoulders as well as targeted stretching and strengthening exercises.

• #43 Cervical Dystonia Treatment Options Explored

  https://drchandrilchugh.com/cervical-dystonia/cervical-dystonia-treatment-options-explored/

  Yes, surgical procedures such as deep brain stimulation and nerve cutting can be considered as treatment options for cervical dystonia. […] Yes, there are ongoing clinical trials testing new treatments, interventions, and tests for cervical dystonia. Participating in these trials can provide access to potentially innovative and more effective treatment options. […] By adopting these lifestyle modifications and incorporating stress management and relaxation techniques into your daily routine, you can effectively manage the symptoms of cervical dystonia and improve your overall quality of life. […] Cervical dystonia is a complex condition that can significantly impact the lives of those affected. While there is no cure, there are various treatment options available to help manage the symptoms and improve overall well-being. Medications, such as botulinum toxin injections and oral muscle relaxants, can provide relief by reducing muscle contractions. Therapies, including sensory tricks, heat packs and massage, and targeted exercises, can help relax the neck muscles and improve flexibility. In more severe cases, surgical procedures like deep brain stimulation or nerve cutting may be considered.

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