II. Epidemiology

  1. Prevalence: 9 per 100,000
  2. Average Age of onset: 40 years
  3. Gender predominance: Women account for 65% of cases

III. Definition

  1. Movement Disorder
  2. Involuntary neck and Shoulder muscle contractions
  3. Head twists into aberrant position

IV. Symptoms

  1. Pain (93%)
  2. Difficult reading, driving, watching television
  3. Withdrawal from social interactions
  4. Abnormal Posture (83%)
  5. Head jerks or neck spasms (62%)

V. Types

  1. Torticollis (neck rotation)
  2. Laterocollis (lateral neck bending)
  3. Retrocollis (neck extension)
  4. Anterocollis (neck flexion)

VI. Causes

  1. Primary or idiopathic cervical Torticollis
    1. Hereditary
      1. Autosomal Dominant
      2. X-linked recessive
    2. Sporadic
  2. Secondary or symptomatic cervical Torticollis
    1. Cervical Lymphadenopathy
      1. Streptococcal Pharyngitis
    2. Hereditary neurologic syndromes
    3. Environmental causes
      1. Neck Trauma (e.g. Whiplash)
      2. Medications
      3. Toxins
      4. Perinatal cerebral injury
    4. Parkinsonism
    5. Psychogenic Dystonia

VII. Labs

  1. Quick Strep Test

VIII. Management

  1. Physical Therapy
  2. Botulin Toxin Type-A (local injection)
  3. Systemic Medications
    1. Anticholinergics
    2. Muscle relaxants

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Ontology: Cervical Dystonia (C0949445)

Definition (MSH) A common form of DYSTONIA due to involuntary sustained or spasmodic, repetitive muscle contractions in the neck region. According to the position of the twisted neck and head, cervical dystonia can be categorized as torticollis, laterocollis, retrocollis, and a combination of these abnormal postures.
Concepts Sign or Symptom (T184)
MSH D014103
Dutch cervicale dystonie, Cervicale dystonie
German zervikale Dystonie, Zervikale Dystonie
Portuguese Distonia cervical, Distonia Cervical
Spanish Distonía cervical, Distonía Cervical
French Dystonie cervicale
Czech Cervikální dystonie, cervikální dystonie
English dystonia cervical, cervical dystonia, cervical dystonias, Cervical Dystonia, Cervical dystonia
Hungarian Nyaki dystonia
Italian Distonia cervicale
Norwegian Cervikal dystoni
Japanese 頚部ジストニア, ケイブジストニア