neurologic disorders
Cervical Dystonia
Diagnosis of Cervical Dystonia
Clinical evaluation The diagnosis of cervical dystonia is based on characteristic symptoms and signs and exclusion of alternative diagnoses, including the following: Tardive dyskinesiacan cause torticollis but can usually be distinguished by a history of chronic antipsychotic use and involuntary movements in muscles outside of the neck. Basal ganglia disordersand occasionallycentral nervous system (CNS) infectionscan cause movement disorders but usually also involve other muscles; CNS infections are usually acute and cause other symptoms. Neck infections or tumorsare usually differentiated by features of the primary process. Antipsychotics and other drugscan cause acute torticollis, but the symptoms usually develop in hours and resolve within days after the drug is stopped. is caused by a benign tumor in the sternocleidomastoid muscle. The tumor causes foreshortening of the muscle and tilting of the neck, mimicking cervical dystonia. Head tilting usually appears during infancy or childhood but can occur during adulthood ( Diagnosis references ). The collis form of dystonia (involving muscles that control the cervical spine) can usually be distinguished from the caput form (involving muscles that move the skull or head joints) based on observation of the patient. Imaging (CT bone window), in addition to clinical evaluation, is useful only for assessing rotation of the head. Lateral shift always occurs when laterocollis is present on one side and laterocaput on the other ( Diagnosis references ). 1.Gonzalez-Usigli H, Espay AJ: A rare cervical dystonia mimic in adults: Congenital muscular torticollis (fibromatosis colli).Front Neurol4 (6), 2013. doi: 10.3389/fneur.2013.00006 2.Reichel G: Cervical dystonia: A new phenomenological classification for botulinum toxin therapy.Basal Ganglia1 (1): 5–12, 2011. 