Cervical Dystonia: The Infrequent Disease as a Paradigm of Differentiated Care in Primary Health Care

Dystonia is a comprised of complex abnormal movements, with most cases being idiopathic. Pharmacological therapy has unfavorable results, and therefore, local botulinum toxin injections are the treatment of choice. In this paper, we report a case of cervical dystonia with a favorable response to levodopa. It is a case of idiopathic cervical dystonia, without a favorable response to local injections of botulinum toxin and a lot of drugs, which was sent to a deep brain stimulation center and, simultaneously, to a Chronic Pain Medical Consultation at the family health unit. At this consultation, treatment with levodopa was tried with a favorable response, avoiding the invasive procedure. The positive results achieved using levodopa agree with other authors who assume that levodopa could be attempted in atypical dystonia. This case highlights the importance of primary healthcare, which can prevent the need for an invasive procedure.