dystonia in adults - NICE guidance - suspected neurological conditions - recognition and referral

Last edited 05/2019 and last reviewed 04/2022

Posture distortion in adults

Summary points from NICE guidance relating to posture distortion in adults are:

Dystonia

  • suspect cervical dystonia in adults who have persistent abnormalities of head or neck posture, with or without head tremor, especially if the symptom improves when the person touches their chin with their hand

  • do not offer cervical imaging to evaluate suspected cervical dystonia in adults

  • be aware that dystonia in adults can affect other parts of the body (for example, it can cause writer's cramp or in-turned posture of the foot)

  • refer adults with suspected dystonia to have an assessment for diagnosis and possible botulinum toxin treatment

Dystonia as a side effect of medications

  • be aware that antipsychotic and antiemetic medicines can trigger or exacerbate dystonia in adults

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