Cervical Dystonia

What Is Cervical Dystonia?

Cervical dystonia, also called spasmodic torticollis, is a movement disorder that causes prolonged and involuntary muscle contraction in the neck.

With dystonia, muscles tense up and cause twisting, repetitive movements, and awkward postures. The condition can be mild to severe and cause painful movements, especially in children. Cervical dystonia symptoms may stay the same or even get better, but they can also get worse over time. Treatments depend on the type, cause, and severity of the condition.

Types of Dystonia

1. Primary dystonia: This form is a genetic disorder that occurs without a brain injury.
2. Secondary dystonia: This is the most common form in children and is often associated with other disorders, such as cerebral palsy.

Both primary and secondary dystonia are location-specific, meaning they affect specific parts of the body and their functions.

Cervical Dystonia Causes and Risk Factors

Cervical dystonia is a neurological condition, which means it starts in the brain. The brain sends abnormal signals to the body’s muscles, which can cause problems with muscle control. It is not yet fully understood what causes the brain to send these abnormal signals.

Some children with the condition may have other neurological problems, such as cerebral palsy. One of the most common causes of dystonia is dyskinetic cerebral palsy, which is characterized by writhing and twisting movements that begin after the first year of life.

Dyskinetic cerebral palsy is caused by injury to the part of the brain called the basal ganglia, which is responsible for movement. Damage to the basal ganglia can occur when a child’s oxygen supply is severely restricted during pregnancy, delivery, or soon after birth.

Cervical dystonia can also be caused by physical trauma to the baby’s head and neck. This can happen if a medically negligent doctor pulls a baby from the birth canal with excessive force, causing harm.

Cervical Dystonia Symptoms

The main symptom of any form of dystonia is overactivity of the muscles, leading to involuntary movement.

These movements typically present as jerking motions of the head, including:

• Chin toward shoulder
• Ear toward shoulder
• Chin straight up
• Chin straight down

Other symptoms include awkward head positioning, headaches, and neck pain radiating into the shoulders.

Parents usually notice that their child frequently trips or falls. In some children, symptoms are more severe in the evening. A child with cervical dystonia may also start walking later than average and may have trouble keeping up with other children their age.

Diagnosing Cervical Dystonia

If your child’s doctor suspects cervical dystonia, they will likely recommend an evaluation by a neurologist. These doctors specialize in brain, nerve, and muscle function and will check your child’s bones, joints, muscles, and reflexes.

Other tests that may be performed to diagnose dystonia include:

• Blood tests
• Electromyography (EMG)
• Genetic testing
• Magnetic resonance imaging (MRI)

The process of diagnosis will include determining what type of dystonia your child has, as well as the likely cause.

Complications From Cervical Dystonia

In some cases, complications involve muscle contractions spreading to nearby areas of the body, including the jaw, face, arms, and trunk. Cervical dystonia can also cause bone spurs, which may involve tingling, numbness, and weakness in the arms, hands, legs, or feet.

Dystonic Storm

Dystonic storm is a rare occurrence that is usually seen in children with pre-existing motor conditions. It involves continuous dystonia that lasts a few hours. It may cause great pain and cause the child to be covered with sweat. If a dystonic storm occurs, take your child to the nearest emergency room.

Cervical Dystonia Treatment Options

Since there is no cure, cervical dystonia treatments are intended to relieve pain and lessen muscle spasms. Children who are still growing need treatment before the dystonia causes permanent bone deformities.

Treatment depends on the severity of the condition. In rare cases, however, the condition resolves without treatment.

Generally, there are three ways to treat dystonia: medication, therapies, and surgery.

Medication

Botulinum toxin is a paralyzing agent that can be injected directly into the neck to reduce cervical dystonia-related muscle contractions.

Examples of medications for cervical dystonia include:

• Botox^®
• Dysport^®
• MYOBLOC^®
• Xeomin^®

Injections need to be repeated every three to four months for most cervical dystonia patients to see an improvement. To enhance results and possibly reduce the number of injections needed, muscle-relaxing oral medications may also be prescribed.

Therapies

Treatment for cervical dystonia may include physical therapy and occupational therapy to help maintain range of motion and prevent muscles from becoming rigid. Speech therapy and behavioral strategies, such as relaxation techniques, may also be used.

“Physical, occupational, and speech therapies give patients more autonomy, progress at school academically and socially, and hope of a successful future.”

– Katie Lavender, RN

Additionally, therapeutic techniques called sensory tricks, which may involve touching the side of the face that is not contracting, can temporarily stop spasms. However, sensory tricks for cervical dystonia tend to lose effectiveness as the condition progresses.

Heat packs and massage can also help relax neck and shoulder muscles.

Surgery and Other Procedures

If other treatments do not help, certain surgeries may be recommended:

• Deep brain stimulation: A small hole is cut into the skull, and a thin wire is guided into the brain. The tip of the wire is placed in the part of the brain that controls movement, and electrical pulses are sent through the wire to interrupt the nerve signals.
• Cutting the nerves: This involves surgically severing the nerves that carry signals to the affected muscles.

Get Legal Help for Birth Injuries

When cervical dystonia is diagnosed in a child, it can steadily get worse over time. Ongoing treatment for the condition can be financially burdensome and mentally exhausting. If you believe your baby’s cervical dystonia was caused by medical negligence, support is available to you.

To learn if you may be entitled to financial compensation to help pay for your child’s costs of care, contact the Birth Injury Justice Center. Our experienced team of Patient Advocates will listen to your story and provide you with a free legal case review.