Cervical dystonia, or spasmodic torticollis is a neurological disease which is based on the incorrect position of the head. It almost does not affect life expectancy, but can cause a lot of problems in everyday life, and the development may even cause complete loss of ability to work and disturbances in the self.
She torticollis can occur due to a large number of reasons and not only acquired, but congenital. Spastic torticollis occurs when a perfectly normal before the muscles begin to from the brain the excess number of signals-stimuli, which leads to an increase in their tone. This suggests that cervical dystonia is an acquired disease, but can develop at any age.
It is important to understand that the normal head position is not controlled by man. That is, the head itself is only proper for her position. And a big role is played by the muscles that help to hold her. In this disease this balance is disturbed and the muscles of one half of the neck outweigh the muscles of the opposite side. And this leads to the fact that the head is fixed in a different, unusual for her position. First, a person is able to get her back in the correct position with an effort of will, then, need the help of the hands, and as soon as the disease will progress to return the head to normal position and does not become impossible.
Many experts believe that the basis for this disease – disorders in the extrapyramidal system of the brain. If in this system there are violations of the established balance, transmission of nerve impulses between cells is also impaired. This leads to excessive impulses which cause the muscles of one or the other half of the neck is heavily reduced. This condition is often hereditary and may appear in the presence of certain predisposing factors:
- Infection of the brain.
- Injuries to the head and neck.
- The neuroleptics.
- Toxic lesions of the brain.
- Strong emotional stress.
In some cases to determine the cause impossible, and then we can talk about idiopathic cervical dystonia. But there is another reason, which recently began to meet more often — it is osteochondrosis of the cervical spine.
The clinical picture
The disease usually occurs in females between 19 and 40 years. It can have acute onset and slow course, the latter option prevails. The main symptom is an incorrect position of the head, and the man have to constantly monitor myself to keep it, as expected. Depending on where the head is rotated, it is possible to allocate following forms of distortion:
- To the side.
- The extension and tilt forward.
- Tilt ago.
- Slope to the shoulder.
But is often found in combined form. Sometimes it so happens that the neck muscles of both sides begin to wrong impulses. In this case one speaks without torticollis torticollis, as bilateral increased tonus does not mind to lean in one direction or another. At the same time, the head cannot be turned to the side, and to look right or left, have to turn the neck and the upper half of the body.
In addition to the incorrect head position, can appear and other symptoms – tremor, which can be subtle or quite strong, intense pain in the muscles, their hypertrophy, a strong and constant voltage.
Almost all the symptoms in the morning are almost entirely absent, but they are growing in a few hours after you Wake up and become especially visible when walking or stressful situations.
Treatment of cervical dystonia should start as early as possible. In the beginning drugs used — it could be the baclofen, clonazepam, carbamazepin, Finlepsin. Sometimes they are combined with antidepressants and other drugs that can be prescribed only by an experienced neurologist.
But the most effective method to date is the introduction of botulinum toxin into the affected muscle. However, the action of this drug lasts only 4-6 months, after which the injection must be done again.
The application of this treatment in almost 60% helps reduce all the symptoms is pain and cramping, relieve tension, increase the intervals when the head is in the normal position.
If conservative therapy does not give any results, the patient with cervical dystonia may have a disability. In some cases, helping surgery, performed by the most modern method where in the brain the electrodes are introduced, blocking the extra impulses coming from the brain to the muscles. It is sometimes the only way to return to a normal lifestyle.