Published online by Cambridge University Press: 02 November 2023
Cervical dystonia (CD) is an idiopathic focal dystonia characterized by abnormal head and neck posture caused by tonic involuntary contractions in a set of cervical muscles. Four subtypes, based on the principal direction of posture, consist of:
- Torticollis: Rotation of the head left or right in the transverse plane.
- Lateralcollis: Head tilt toward left or right shoulder, in the coronal plane.
- Anterocollis: Head tilt forward, with neck flexion in the sagittal plane.
- Retrocollis: Head tilt backward, with neck extension, in the sagittal plane.
The clinical spectrum of CD is extremely variable: the 54 muscles involved in head and neck posture may show complex mixtures of involvement, unilateral or bilateral, with contractions of tonic, tremulous or myoclonic character. Currently, the most effective, and now first-line treatment of CD, has become intramuscular injection of botulinum toxin.
This chapter enumerates the different muscles involved in major subtypes of CD, grouped by anatomical location, and their principal direction of action. Sets of muscles involved in different head postures are presented in tabular format for easy selection and targeting. Dose ranges for individual muscles are tabulated for each of the four commonly used botulinum neurotoxin preparations.
To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Find out more about the Kindle Personal Document Service.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.