title: Headache Attributed to Craniocervical Dystonia - A Little Known Headache.
abstract: BACKGROUND
  Craniocervical dystonia is a focal or segmental dystonia in its distribution, classically known as spasmodic torticollis when in its pure cervical presentation. Although craniocervical dystonia has been recognized as a possible cause of headache since the publication of the second version of International Classification of Headache Disorders, there are few studies about this entity.
  
  
  METHODS
  This was a narrative review.
  
  
  RESULTS
  Craniocervical dystonia was associated with muscle pain in 67-89% of the cases. Headaches of any kind affected approximately 60% of patients with craniocervical dystonia, and were located mainly in the occipital and cervical regions. Headache attributed to craniocervical dystonia specifically was rarely found, and it was described in only one patient out of 80 in one study. Treatment with botulinum neurotoxin is considered to be the first-line treatment for focal dystonias, including craniocervical dystonia, and besides reducing clinical severity, impairment, and pain scores among the patients with craniocervical dystonia, there were also descriptions of improvements in headaches attributed to craniocervical dystonia and other headaches associated with this dystonia.
  
  
  CONCLUSIONS
  Headache attributed to craniocervical dystonia has been poorly studied. There is a need for more studies to evaluate its characteristics and treatment.
authors.affiliation: Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.
authors.forename: Marcos Eugenio Ramalho
authors.initials: ME
authors.lastname: Bezerra
authors.affiliation: Department of Neuropsychiatry, Universidade Federal de Pernambuco (UFPE), Recife, Brazil and Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil.
authors.forename: Pedro Augusto Sampaio
authors.initials: PA
authors.lastname: Rocha-Filho
mesh_terms: D006261:Headache / Q000209:etiology* / Q000628:therapy; D006801:Humans; D014103:Torticollis / Q000150:complications* / Q000628:therapy
keywords: botulinum toxins; cervical dystonia; dystonia; headache; headache disorders; pain; primary; secondary