To spasm , or Not to Spasm , That is the Question Case Report

Introduction Typically, cervical dystonia (CD), or spasmodic torticollis, is described as a condition in which the cervical paraspinal muscle groups in the neck undergo uncontrollable and prolonged spasm. It has been well described in the literature that CD presents in most patients with an extreme head tilt or tremor due to spasm. This has become the all-encompassing definition of CD to many clinicians. However, in a medical review of over 260 patients with CD, the authors found that only 62% of patients present with the symptoms of spasmodic torticollis [1]. This means that 38% of CD cases do not manifest in a significant head tilt or tremor, which we will refer to as atypical cervical dystonia [1]. We describe a case of atypical cervical dystonia in which OnabotulinumtoxinA (ONA) was used to successfully treat the condition.