Spasmodic torticollis, diagnosis and treatment

Spasmodic torticollis refers to one of the most common types of focal (unilateral) dystonia in the adult population. In most cases with this disease, spasticity of muscles is the only symptom that is associated with neurophysiological disorders in the brain stem and basal nuclei. The disease, as a rule, is diagnosed after 30 years and at first has a transient character, later the manifestations become permanent. Only in 10% of cases there are remissions, but complete recovery does not occur. Spasmodic torticollis manifests itself by forcible turning of the head to the side, sometimes by tilting or reclining backwards. Some patients try to weaken the dystonia with special methods, for example, leaning their nape against the wall, holding their chin by the hand, lying down. The spasticity of the muscles of the neck disappears in a dream, and increases with tension and anxiety. People with long-suffering torticollis develop cervical osteochondrosis and radiculopathy, which are accompanied by pain in the arm and neck.

Diagnostics

When diagnosing "spasmodic torticollis", one should always consult a neurologist. In order to determine the diagnosis and prescribe the appropriate appropriate treatment, apply such types of research:

• X-ray (with functional tests);

• Cardiovascular (rheoencephalography);

• The analysis of blood supply of vertebral and carotid arteries in a state of rest, with a turn of the head, its inclinations in different directions;

• Blood vessel analysis, arterial tone, peripheral vascular resistance, vein tone, lability of the vascular wall;

• Electromyographic research;

• Research potentials caused in the brain;

• Analysis of acoustic stem potentials;

• Study of induced somatosensory potentials;

• Magnetic transcranial stimulation.

Krivosheya, treatment

Spasmodic torticollis refers to diseases that are difficult to treat. Adequate treatment methods are difficult to pick up because the spasticity syndrome is caused by the persistence of the pathological changes underlying the disease.

Spasmodic torticollis is partially treated with drugs designed to relieve spasm of the muscles of the neck. For a long time, adrenomimetics and central anticholinergics were used for these purposes. Today, the most effective means is botulinum toxin type A. In this case, in order to maintain the tone of the neck muscles in a normal position, this drug is injected into the diseased muscle. There is a temporary blocking of the wrong signals, but as soon as the effect of the effect ends, a second injection must be carried out.

After the procedure of medicamentous blocking of the activity of the main factor, it becomes necessary to normalize the functions of the spine as a whole and to act on the peripheral focus by means of acupuncture and manual therapy. To do this, post-isometric relaxation of the muscles of the neck, shoulder and mobilization of the joints of cervical vertebral segments is used, combining it with auricular and corporal acupuncture.

At the third stage of treatment, the damaged dynamic stereotype is corrected . This is the longest period, requiring perseverance and patience on the part of the doctor and the patient. Spastic torticollis is characterized by the most important pathological stereotype - lifting of the shoulder from the side of the head rotation, which is reflected in subsequent changes in the locomotor system of the spine as a whole. To destroy this stereotype, the techniques of autorelaxation and special exercises are used.

Thus, the necessary and paramount condition for effective treatment is the suppression of the effect of the central factor using botulinum toxin type "A" and a new generation drug - Xeomin®.