Objective: To present a case of cervical dystonia misdiagnosed as anxiety disorder for five years, emphasizing the critical need for timely recognition and appropriate treatment of this movement disorder.

Background: Cervical dystonia, a focal dystonia characterized by involuntary contractions of neck muscles, can significantly impact patients’ quality of life. Misdiagnosis and delayed treatment are common due to its variable presentation and the limited awareness among general practitioners. Median delay of diagnosis of 1 year, with some patients experiencing delays of up to 10 years or more has been reported. This case report illustrates the consequences of delayed diagnosis and the importance of specialist evaluation.

Method: The patient’s medical history, clinical presentation, diagnostic journey, and treatment outcomes were reviewed.

Results: This 55-year-old female patient, initially presenting with involuntary head movements/jerky motion of the head several months after a car accident, consulted three healthcare providers over five years (1 general practitioner, 1 general neurologist and 1 physiotherapist). She was repeatedly misdiagnosed with anxiety disorder and prescribed benzodiazepines, which proved ineffective. The patient’s symptoms persisted, leading to significant physical discomfort and psychosocial distress with serious consequences on her personal and professional life. Upon evaluation by a movement disorders specialist, cervical dystonia was diagnosed. Treatment with botulinum toxin injections was initiated, resulting in substantial symptom improvement and enhanced quality of life.

Conclusion: This case emphasizes the value of specialist evaluation in movement disorders and the potential for effective treatment in cervical dystonia. The five-year delay in diagnosis highlights the need for increased awareness of cervical dystonia among healthcare providers and the critical role of timely referral. Early recognition and appropriate treatment can significantly improve patient outcomes and prevent unnecessary psychological distress and inappropriate medication use.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/delayed-diagnosis-of-cervical-dystonia-a-case-report-highlighting-the-importance-of-an-on-time-specialist-evaluation/