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Selective peripheral denervation of cervical dystonia

Guidance issued Guidance issued
 
IP Guidance Number: IPG80
 
Summary:

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on selective peripheral denervation for cervical dystonia.

Description:

Cervical dystonia is a condition in which the muscles of the neck contract painfully and cause twisting of the head. It may be congenital, but may also occur at any age. Cervical dystonia may persist for several years, and sometimes for life. About 20% of people will recover without treatment.

Cervical dystonia varies according to which muscle groups are affected. The head may be pulled backwards (retrocollis), forwards (anterocollis) or to the side (torticollis).

The cause of cervical dystonia is not known. In children, it is sometimes associated with congenital abnormalities of head shape or spine.

Standard treatment for cervical dystonia includes physiotherapy, drugs to reduce spasm, injections of botulinum toxin and brain surgery. Peripheral denervation has been advocated as an alternative, especially in people who have not responded to other treatments.

Selective peripheral denervation is a surgical approach which involves cutting the nerves to the muscles of the neck through a large skin incision. The surgery is carried out under general anaesthetic. The procedure varies according to the muscle groups affected, and whether it involves cutting of the muscles.

Arrangements:

Other (see guidance)

Topic Area:

Central nervous system
Musculoskeletal

Specialty:

Neurosurgery
Trauma and orthopaedic surgery

Specialist advice has
been sought from:

Society of British Neurological Surgeons

British Orthopaedic Association

Date notified to NICE: 01 April 2002
Guidance Publication Date: 25 August 2004
Contact Details:
Project Manager
(for general enquiries or comments)
Ben Doak
Contact Address:

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA


Links:

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