neck postures of cervical dystonia

Q: Name at least three abnormal neck postures of cervical dystonia.

Answer: Abnormal neck posture is the defining feature of cervical dystonia, which is present only while a patient is awake. Chronic musculoskeletal deformities may occur over the years. This can be socially very unpleasant and disturbing to a patient and people.

• Torticollis – Rotation to either direction in the transverse plane
• Laterocollis – Lateroflexion to either direction in the coronal plane
• Retrocollis – Retroextension in the sagittal plane
• Anterocollis – Anteroflexion in the sagittal plane
• Sagittal shift – Base of the neck is shifted in the sagittal plane
• Horizontal (lateral) shift – Base of the neck is shifted towards either shoulder

Antero- and retrocollis occur exclusively alone. All others may exist in combination.

Further sub-classifications have been described, but details can be extensive (out of the scope of our small pearls). 

Botulism may help.

#neurology

#musculoskekeletal

References:

1. Jankovic J, Leder S, Warner D, Schwartz K. Cervical dystonia: Clinical findings and associated movement disorders. Neurology 1991; 41:1088.

2. Reichel G. Cervical dystonia: A new phenomenological classification for botulinum toxin therapy. Basal Ganglia 2011; 1:5.

3. Jost WH, Tatu L, Pandey S, et al. Frequency of different subtypes of cervical dystonia: a prospective multicenter study according to Col-Cap concept. J Neural Transm (Vienna) 2020; 127:45.