Cervical dystonia, polyneuropathy and edema: Prof. Rafi Carso explains

“Cervical dystonia is a condition in which uncontrolled and unbalanced activity of the neck muscles occurs. The phenomenon can appear as a separate problem, or as part of the symptoms of Parkinson’s disease. The conventional treatment is based on the injection of botulinum toxin to relax the contracted muscles, but the success of the treatment requires great precision in the choice of the muscle and the dose. An ultrasound-guided injection allows the doctor to observe the deep neck muscles in real time and direct the substance precisely to the contracting muscle, which increases the chances of success.

“Alongside the injections, it is sometimes recommended to combine systemic drugs for muscle relaxation and targeted physiotherapy, the purpose of which is to sharpen movement control and strengthen opposing muscles. In particularly resistant cases, you can consult dedicated clinics for movement disorders regarding additional advanced options. The therapeutic goal is always to find the delicate balance between reducing pain and contraction and maintaining the stability of the neck and head.”

“Polyneuropathy means damage to the peripheral nervous system that involves several nerves at the same time, usually symmetrically in both legs. When the damage is sensory, the brain disrupts the signals and interprets them as discomfort, ‘gravel’ sensations, extreme cold or burning. And when there is motor involvement, there may be difficulty in muscle activation, which is manifested, for example, in difficulty getting up from a chair. The causes of polyneuropathy are very diverse, starting with changes genetic or age-related, through metabolic problems to nutritional deficiencies.

“As a first step, it is recommended to make sure that a comprehensive blood test for vitamin B12 is performed, since sometimes there is a problem with its absorption in the digestive system even in those whose diet is rich. In these situations, a dedicated supplement may be needed. In addition, drugs to prevent nerve pain affect each person differently. Treatment is started at a low dose and gradually to prevent fatigue, and a drug can be changed if the given drug does not improve the quality of life. Physical activity and physiotherapy are very important to maintain Muscle strength and balance, but severe discomfort should not be ignored. If prolonged walking increases the burning sensation, it is correct to shorten the distance, stop for regular rests and not cross the pain threshold.”