Quality of life in patients with cervical dystonia

As cervical dystonia (CD) is a chronic disorder with a mean age at onset of around 40 years, the patients need effective treatment for several decades. Botulinum toxin (BTX) injections provide relief of symptoms and functional improvement for the majority of patients, an effect that seems to be sustained also with long-term treatment. In a cohort of 78 CD patients who had been treated with BTX type A for a median of 5.5 (1.5–10) years, the effect of long-term treatment was assessed retrospectively both by the patients and the treating neurologists. Two thirds of the patients were evaluated to have a good effect (; significant improvement of both symptoms and function) and one third a less satisfactory effect. Health-related quality of life (HrQoL) was measured using the Short Form-36 (SF-36), and was completed by 61 patients (78%) at the time of treatment evaluation. In SF-36 a score from 0 (worst possible HrQoL) to 100 (best possible HrQoL) is yielded for eight domains. When compared with an age-matched community sample, the SF-36 scores of the CD population were markedly reduced for the domains pain, general health perception, vitality, role limitation due to physical problems and role limitation due to emotional problems, whereas only a slight reduction was found for physical function, social function and mental health. We discuss which factors that might explain the significant impact of CD and botulinum toxin treatment on certain aspects of HrQoL, based on our own findings and the literature.