Guide To The Causes Of Cervical Dystonia

Cervical dystonia, otherwise known as spasmodic torticollis, is a rarely occurring condition that causes the muscles of the neck to undergo involuntary contractions. This leads them to twist into abnormal positions, which in turn causes the head to move in involuntary ways. Some patients might experience twisting of their chin or ear toward their shoulder, or movement of their chin straight down or up. Others might have postural abnormalities like one raised shoulder. Muscle spasms and spasticity are often very painful for individuals with cervical dystonia. Understanding the causes of the condition is important to know how to manage it properly.

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Family History And Genetics

Genetics and family history appear to play a role in some cases of cervical dystonia. Researchers estimate between ten and twenty-five percent of cervical dystonia patients also have a family history of the condition. The condition is estimated to affect around sixty thousand individuals in the United States, so up to fifteen thousand of those have a family history of it. Genetics may increase an individual's chances of developing cervical dystonia, but researchers believe genetics alone are not responsible. Instead, genetics are combined with a variety of environmental and physical factors to increase the risk of developing cervical dystonia. Researchers have discovered cervical dystonia tends to present in individuals who have mutations in one or more of several genes. Gene mutations linked to cervical dystonia have been identified in the ANO3, CIZ1, THAP1, and GNAL genes. With that said, not enough information is currently available about how the mutations affect an individual's chances of developing cervical dystonia. Because of this, there is no way to do a genetic test for diagnostic purposes with cervical dystonia, and the condition must be assessed through symptoms and family history alone.

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Certain Injuries

Certain injuries may cause an individual to develop cervical dystonia. In cases where there's an underlying cause like an injury or neurological disorder, the condition is called secondary cervical dystonia. Injuries to the shoulders, neck, or head increase the likelihood of an individual developing cervical dystonia. This may be considered a kind of post-traumatic dystonia, which is dystonia that occurs after an injury or trauma to the affected body part. The most common injury leading to cervical dystonia is whiplash, which some individuals experience in car accidents or when suffering impacts at sporting events. Whiplash occurs when the head snaps quickly backward and forward in a way that causes muscle injury. If individuals suspect they have suffered a whiplash injury, they should have their neck evaluated to make sure no damage was done to their spine. It's important to be attentive during the rehabilitation process for an injury. If patients notice they're developing symptoms of abnormal tension or spasticity, they should talk to their doctor to see if there are ways to mitigate it.

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Age And Gender

Age and gender don't appear to cause cervical dystonia by themselves. There have been cases where individuals of all genders and ages were affected, including children and the elderly. However, an individual's age and gender do appear to affect their risk of developing cervical dystonia. Around twice as many women develop cervical dystonia than men. In addition, most patients who develop the condition are between forty and sixty years old. One study indicated men with cervical dystonia tend to develop the condition at a significantly earlier age than women with cervical dystonia, which is interesting. If it's true that men are more likely to present with symptoms earlier, then they may be statistically more likely to develop the condition before turning forty years old. In addition to cervical dystonia, the study found men were likely to develop focal, primary segmental, laryngeal, and blepharospasm-related dystonia at earlier ages of onset than women. It's not well-known what sex-linked factors cause this discrepancy, nor is it known why women more commonly develop cervical dystonia than men.

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Presence Of Neurological Disorders

The presence of neurological disorders can influence the development of cervical dystonia. In these cases, it's common for patients to have other types of dystonia as well. The neurological disorders might have other neurological symptoms. These are cases of secondary dystonia that should be treated by first treating the underlying neurological condition. One of the most common neurological disorders that can result in dystonia, including cervical dystonia, is Parkinson's disease. Parkinson's disease, which first causes movement issues, is progressive and terminal. Patients with Parkinson's disease have reduced dopamine levels because the part of the brain that creates dopamine begins to die. This leads to a lack of coordinated and smooth muscle movement. When anywhere from sixty to eighty percent of the cells of this part of the brain have died, Parkinson's disease symptoms will begin appearing. In addition to developing cervical dystonia, it's common for patients to develop a tremor, stiffness in the arms and legs, and trouble with walking. They might have a tendency to fall, experience issues with maintaining their balance, and their movements might be slow.

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Certain Medications

Certain medications have been known to cause cervical dystonia and other types of dystonia as a side effect. This is most commonly reported with medications that block the brain's release of dopamine, which is required for the smooth and controlled movement of muscles. If individuals don't have enough dopamine, their muscles may spasm or become tense and rigid. When this is the case, they might develop cervical dystonia alongside other muscle problems. Many antipsychotics block dopamine in the brain, since psychotic symptoms have been linked to increased dopamine levels. Some medications that block dopamine and may cause dystonia include clozapine, quetiapine, risperidone, paliperidone, promethazine, metoclopramide, and chlorpromazine. If individuals are experiencing painful muscle symptoms as a side effect of their medication, they should talk to their doctor about lowering their dose or switching to a different type of medication. Sometimes changing medications or adjusting the dosage will be enough to stop the symptoms from continuing.