Cervical dystonia treatment with botox

What is cervical dystonia?

Cervical dystonia is a painful affliction that can affect people of any age wherein the muscles of the next contract involuntarily. These contractions can cause the head to turn or twist to 1 side, or cause the head to tilt forward or backward on its own. This condition is also called spasmodic torticollis, and though it can occur at any time, it most commonly affects middle-aged women most often. There is currently no cure for this affliction, though sometimes it does resolve without treatment. Botulinum toxin, the active ingredient in Botox, is able to treat cervical dystonia and improve the signs and symptoms of the condition. Cervical dystonia is a neurological disorder and typically occurs gradually with smaller symptoms that worsen over with time.

Cause and symptoms

As cervical dystonia occurs gradually, it is important to pay attention to the early symptoms that may indicate that the condition is developing. These early symptoms include:
  • Mild jerking head movements;
  • Stiffness in the neck;
  • Localized neck discomfort.
These symptoms can often worsen temporarily during periods of stress or excitement. As the condition progresses, new symptoms arise, typically in the form of abnormal posture, including:
  • The chin twisting abnormally toward the shoulder, also known as torticollis;
  • The ear tilting toward the shoulder, also known as laterocollis;
  • The chin twisting straight down, also known as antecollis;
  • The chin twisting straight down, also known as retrocollis.
There is no definite known cause for cervical dystonia, though it is sometimes associated with other conditions such as spasticity, Parkinsonism, or ataxia. For isolated cervical dystonia, there are a few things that could be the cause, including:
  • A family history of the condition (in 10–25% of cases);
  • Gene mutation.
  • If there is an identifiable cause, this is referred to as secondary cervical dystonia. Identifiable causes may include:
  • Head, neck, or shoulder injury;
  • The use of drugs such as anti-psychotics, nausea medication, or dopamine receptor blockers.
  • Types:

    There are different types of cervical dystonia that can be classified based off the cause of the condition. Determining the type of cervical dystonia the patient suffers from is integral in figuring out how to properly assess and treat the condition, as different treatment options may be required on a case by case basis.
  • Primary cervical dystonia is when this is the only neurological disorder that the patient suffers from. This is the classification regardless of whether or not the patient has a family history of the disorder. If the patient does have a family history, it is likely that they also have early-onset generalized dystonia, a condition that is associated with the DYT1 gene.
  • Secondary cervical dystonia occurs when there has been some kind of physical trauma, such as a head, neck, or shoulder injury that has brought about the onset of the symptoms of the condition.
  • Treatment

    There are a few treatment options that are available to patients suffering from cervical dystonia:
  • Deep brain stimulation for cervical dystonia is being explored as a new treatment option. This involves implanting a battery-powered stimulator into the brain through a surgical procedure. Essentially, the stimulator would be like a pacemaker for the brain, and would deliver electrical currents to certain areas of the brain that are associated with the dystonia.
  • Botox injection for cervical dystonia is 1 of the most effective and safe treatments available. Regular injections with botulinum toxin, the active ingredient in Botox, help to block the signals from the brain to the nerves that tell the muscles in the affected area to contract. This essentially paralyzes the muscle, reducing the amount of contractions and spasms within the muscle.
  • It is important to note that a Botox dose for cervical dystonia is not comparable to the dose of any other botulinum toxin product, as each brand has its own units of measurement to determine dosage. Dosage should be determined on a case-by-case basis, and a lower dose should be used on patients receiving Botox injections for the first time. No more than 50 units should be administered per injection site. Injections can be administered no sooner than every 3 months.

    Side effects

    Though Botox has been used to treat cervical dystonia since it was approved for use by the FDA in 1989 and is proven to be both safe and effective, there are still some undesired side effects that may occur after treatment. Mild side effects:
  • Headache
  • Cough
  • Flu-like symptoms
  • Back pain
  • Inflammation of nasal passages
  • Dizziness
  • Nausea
  • Drowsiness
  • Fatigue
  • Soreness at the injection site
  • These reactions are temporary and should resolve themselves within a few days. Though rare, there are some more serious side effects that require immediate medical attention. Rare reactions:
  • Problems swallowing, speaking, or breathing
  • Spread of toxin effects as exhibited by blurred vision, drooping eyelids, hoarseness of voice, and overall muscle
  • weakness


    There are multiple botulinum toxin products available on the market other than Botox. It is once again important to note that the dosage is not interchangeable between brands. Injectable botulinum toxin products include: Dysport; Botox; Myobloc, marketed as Neurobloc in Europe. Dysport and Botox are both formulated using botulinum toxin type A, while Myobloc is formulated with botulinum toxin type B. Despite this difference, all injections are able to help treat cervical dystonia.


    Though there is still a lot that is unknown about cervical dystonia, and there is no known cure for the condition. Still, there are treatments available to help manage the painful and oftentimes debilitating issue. Botox injections are a quick, easy, and safe treatment to help individuals suffering from cervical dystonia to continue on with their regular life without the inconvenience of this involuntary neurological condition. If you are noticing some of the early symptoms of cervical dystonia, or have been diagnosed with this condition, then speak to your doctor about receiving Botox injections for cervical dystonia.

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    Disclaimer: These articles, and any views and opinions expressed, are not endorsed by Raskel Medical. The articles are strictly for informational purposes and should not be considered medical advice. Raskel Medical does not check or edit the content of these articles for medical accuracy. Contact your medical practitioner for any medical advice needed.