How can cervical dystonia be managed in females at 34?

Question

Hello doctor,

My 34-year-old daughter has been dealing with cervical dystonia for two years now, and her symptoms have worsened significantly since having her second baby six months ago. The neck spasms are so severe that she struggles to hold the baby properly, and breastfeeding is becoming nearly impossible.

She had been receiving Botox injections every three months, but these were stopped during pregnancy, and now the waiting list to restart treatment is four months long. She has also developed writer's cramp in her dominant (right) hand, making it challenging to sign documents at work.

Additionally, her menstrual cycles have become irregular since her dystonia worsened, and she is concerned about the possibility of becoming pregnant again. Muscle relaxants like Baclofen make her too drowsy to care for her children safely.

She is currently under the care of a neurologist and is trying to get an appointment at a movement disorder clinic, but the wait times are several months. Is there anything safe she can do to manage her symptoms while breastfeeding? The constant neck pain is severely affecting her, and she is barely sleeping at night.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Cervical dystonia is a neurological condition that affects the brain and nerves, causing involuntary muscle contractions in the neck. When these muscles contract, they tighten and cannot relax, affecting posture. As a result, your head and neck may make abnormal movements, often resembling spasms or jerks. This condition can lead to pain, discomfort, and difficulty with day-to-day activities.

Cervical dystonia is classified as a type of focal dystonia, a group of disorders that cause muscle spasms in a specific part of the body. You may also hear your healthcare provider refer to cervical dystonia as spasmodic torticollis.

Types of cervical dystonia

There are two types of cervical dystonia, distinguished by their cause:

Primary cervical dystonia: The exact cause is unknown.
Secondary cervical dystonia: The cause is identifiable, often related to injury, medication side effects, or another neurological condition.

Symptoms of cervical dystonia: Cervical dystonia can cause involuntary movements such as:

Spasms: Muscles become tight and complex, and they cannot relax. Twitching or sudden jerking movements may also occur.
Tremors: Certain body parts, such as the arms, may shake uncontrollably.

Management recommendations: I recommend consulting a neurologist, preferably a specialist in movement disorders. I suggest you take:

Tablet Naproxen 500 mg: Take one tablet twice daily (morning and evening) for pain relief.
Tablet Tizanidine 4 mg: Take one tablet twice daily to help with muscle relaxation.
Tablet Cholecalciferol (Vitamin D3) 2000 IU: Take once every 10 days for four months to support bone and muscle health.
Voltral emulgel (diclofenac diethylammonium): Apply to the neck twice daily to reduce pain and inflammation.

Consult your specialist doctor, discuss with them, and take the medicines with their consent.

I hope this helps you.