How can my sister, 34, manage her neck dystonia and spasm?

Question

Hello doctor,

My 34-year-old sister has been having these weird muscle spasms in her neck and shoulders for about six months now. It started gradually, but now her head keeps turning to the right involuntarily, and she cannot control it. She is embarrassed to go out because people stare at her twisted posture.

The neurologist said it might be dystonia and prescribed some Botox injections, but we are scared about putting toxins in her body. She used to be a teacher, but had to take leave because the kids were getting distracted by her movements. The muscle relaxers make her too drowsy to function properly.

Are there any other treatment options available? We have heard about deep-brain stimulation, but that sounds terrifying. She is getting depressed because this is affecting her whole life and career. Please help us understand what we can do to get her normal life back.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com

I understand your concern.

Symptoms and history could be due to a neurological movement disorder called cervical dystonia or spasmodic torticollis. The patient's neck muscles contract, causing involuntary movements of the head and neck, leading to bending and turning, which can be painful.

The most probable cause is a neurological movement disorder.

The different treatment options include:

Botulinum toxin injections: It is the first line of treatment for cervical dystonia. It acts by blocking abnormal nerve signals to the overactive muscles of the neck. With consistent use for about four to five months, patients respond with better clinical outcomes.
Deep brain stimulation: This is helpful to control muscle movement. It is mainly reserved as the last option if the botulinum toxin injections do not show a positive response.
Anticholinergic drugs like Trihexyphenidyl: It is a muscle relaxant like Clonazepam and can help with muscle contraction. It can have side effects, such as sedation.
Physiotherapy and occupational therapy: To improve posture and muscle contraction.
For depression, support groups can be joined where psychological support is provided and various coping strategies are explained.

Botulinum toxin injections will be the best treatment for your sister. They should be started under a physician's observation and considered safe if taken properly. Delaying the treatment may cause worsening of symptoms.

The above-mentioned treatment advice will help in muscle relaxation, but still, Botulinum toxin injections are the first-line treatment for the patient.

I hope this answers your query.

Thank you.