- Focal dystonia
- Spasmodic torticollis
- 333.83 Spasmodic torticollis
- G24.3 Spasmodic torticollis
- Dystonia is a condition that is characterized by involuntary intermittent or prolonged muscular contractions, such as twisting or repetitive movements, which may cause abnormal postures and movements
- Dystonia may be generalized or focal
- Cervical dystonia (CD) is the most common focal dystonia
- Cervical dystonia is commonly referred to as spasmodic torticollis, which may be misleading
- Spasmodic describes movements that are intermittent or clonic and tremulous, though some patients with CD present with prolonged contractions
- Torticollis implies rotary impairment, though patients with CD often present with combined postures associated with flexion, extension, and side-bending
- Further classification may be based upon head position or movement2
- Traditional classification is based upon etiology
- Primary (idiopathic)
- Secondary (of known cause)
- Current classification describes each person based upon the following characteristics
- Age of onset
- Distribution of symptoms
- Common to patients with primary and secondary CD
- Enlargement of the neck muscles
- Shoulder elevation on affected side
- Ipsilateral head tilt and contralateral head rotation
- Head tremor or spasmotic jerking
- Tremors of the arm
- Possible difficulty swallowing
- Unique to patients with post-traumatic CD
- Marked limitation in range of motion
- Lack of improvement after sleep
- Lack of Geste antagoniste, also known as sensory tricks, are physical positioning, such as touching the chin, which have been shown to temporarily reduce dystonia5
- Postural control abnormalities
- Greater reliance on vision for maintaining postural stability1
- Reduced ability to perform activities of daily living involving head or neck movements
- Difficulty sleeping
- Reduced psychosocial functioning
Possible Contributing Causes
- Primary cervical dystonia
- Secondary cervical dystonia
- Dopamine agonists
- Antimalarial drugs
- Environmental toxins
- Carbon monoxide
- CNS lesions
- Intramedullary lesions of the cervical cord
- Focal brain lesions, such as vascular malformation, tumor, ...
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