Unusual cervical involvement in psoriatic arthritis and the presence of cervical and facial dystonia: a case report

Psoriatic arthritis (PsA) exhibits the most prevalent occurrence of cervical spine involvement within the spondyloarthropathies. The disease can progress and cause C1-C2 arthritis, erosions of the odontoid process, atlantoaxial instability, syndesmophytes, ankylosis, osteitis, ossifications, and compression of the spinal cord. Dystonia is a neurological movement disorder that causes involuntary and prolonged muscle contractions, twisting, repetitive movements, and atypical body positions. The occurrence of atlantoaxial distention and degeneration may be observed as a consequence of cervical dystonia, potentially leading to the development of cervical dystonia. This report presents a clinical case of an individual afflicted with PsA as well as cervical and facial dystonia, which includes the manifestation of atlantoaxial degeneration and pannus formation. The case was successfully managed through the administration of secukinumab and botulinum toxin injections.