Q: I am 60 years old. On my complaining of a severe pain in the neck, after lots of diagnosis by an orthopaedist, I was advised to consult a neuro-physician who diagnosed me as suffering from dystonia of neck. The pain in the neck was for about last three years. Neuro-physician advised me to take Pacitane 2 mg tablets four times a day and wear a neck collar whole day. There is also small movement/distortion/vibration in jaw while talking. Pain in neck is still there. Is there any permanent cure for the disease which can give me relief from pain or I will have to continue like this. Please advise.

A:In Dystonia the main problem is involuntary movement of the neck to one side or other. The movement causes the pain so you must have movement and pain for diagnosis of dystonia. The best drug is Pacitane. If 4 tab are not enough you can try 5, 2 morning, 2 afternoon and 1 at night and then increase to 6 and can then increase slowly to even 10. With that you may use Tryptomer 10 mg, 2 at bedtime. If all this does not help you may see a neurologist for Inj. of Botox in muscles of neck. This may cost Rs 15000/- at a time and may have to be repeated every 6 months, so most patients prefer to remain on oral drugs only.