Cervical dystonia, also known as spasmodic torticollis, is a focal dystonia that causes involuntary muscle contractions of the neck and shoulders that result in twisting and/or abnormal postures. Movements are tonic (sustained) and/or clonic (jerky). The disease may be accompanied by pain (over 70% of patients), reduced range of motion, and/or irregular head tremor. The muscle contractions can lead to turning of the head / neck (torticollis), lateral tilting of the head / neck (laterocollis), flexion of the head / neck (anterocollis), and/or extension of the head / neck (retrocollis).
This type of dystonia typically starts after age 30. Symptoms can progress for about 5 years and then typically plateau. Occasionally, affected individuals develop other focal dystonia, but it rarely becomes generalized dystonia. Etiology is often unknown (idiopathic), but it can be secondary to genetic abnormalities or medications.
Cervical dystonia
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Synopsis

Codes
ICD10CM:
G24.3 – Spasmodic torticollis
SNOMEDCT:
74333002 – Spasmodic torticollis
G24.3 – Spasmodic torticollis
SNOMEDCT:
74333002 – Spasmodic torticollis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Arthritis
- Cervicalgia
- Cervical radiculopathy
- Tardive syndrome
- Essential tremor (head tremor is more regular)
- Wilson disease
- Huntington disease
- Parkinson disease
- Corticobasal syndrome
- Multiple system atrophy
- Progressive supranuclear palsy
- Tics
- Fourth cranial nerve palsy leading to head tilt as a compensatory mechanism
- Psychogenic movement disorder
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:09/18/2017
Last Updated:05/15/2023
Last Updated:05/15/2023