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PubMed1987

[Psychopathologic symptoms in torticollis spasmodicus].

The paper presents the results of detailed diagnosis of 51 patients with torticollis spasmodicus. A discussion of the results would seem to indicate the possibility of there being one group with prior neuroses, one group compulsive in nature, and one group whose diminished performance arises from the condition of the brain. Reliable diagnosis is only possible when both mental and physical parameters have been taken into consideration.

Adult↗
PubMed1986

[Long-term follow-up study of spasmodic torticollis].

Since 1958, 61 patients with spasmodic torticollis, 46 of whom did not develop other kinds of involuntary movements, have been experienced in our neurosurgical clinic. The course of these 46 patients was followed for more than one year. The retrospective analysis revealed 25 patients were treated conservatively, and 21 patients were treated surgically. Surgical treatment consisted of stereotactic ventrolateral thalamotomy in 19 patients, and Olivecrona's operation in the other 2. The long-term outcome of conservative therapy was compared to that of surgical therapy. One patient with severe retrocollis with horizontal components was treated successfully but transiently by implantation of stimulating electrodes in the cervical epidural spinal cord. The peak incidence of the onset of the disease was in the fourth decade; however, the time of onset ranged from 7 to 55 years of age. The period from disease onset to the final evaluation in the follow-up was 9.3 years (mean) in the conservative group, and 8.5 years in the surgically treated group (no significant difference). There were no significant differences between the groups in the interval from the time of disease onset to the initial evaluation in our clinic, stage determined at evaluation, and follow-up period after the initial evaluation. Of the 25 conservatively treated patients, symptoms and signs remained unchanged in 8, deteriorated in one, but improved significantly in most of the remaining patients. Many of the surgically treated patients showed improvement one week after surgery, but the long-term outcome was not significantly better than that of the conservatively treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Traumatic spondylolisthesis of the axis in a patient presenting with torticollis. A case report.

In a 34-year-old man with an acute traumatic spondylolisthesis (ATS) of the axis, the presenting physical sign was severe torticollis associated with reactive spasm of the right sternomastoid muscle. Computed axial tomography (CAT) was useful both in assessing the nature of ATS (which involved more displacement of the axis fracture and adjacent soft-tissues on the right side of the neck) and in ascertaining reduction, realignment, and healing. The reduction was sustained by halo-vest immobilization.

Adult↗
PubMed1987

[Spastic torticollis (clinical picture, etiology, pathogenesis)].

On the basis of observation of 51 patients with spastic torticollis (ST) the authors describe in detail the clinical picture of the disease, with the dystonic-hyperkinetic syndrome being its principal feature. ST is always caused by involvement of the extrapyramidal system, more frequently of its formations located in the upper portions of the brain stem. In the overwhelming majority of cases the underlying cause of ST is neuro-infection, predominantly epidemic encephalitis. In some cases ST etiology is insufficiently clear: a number of suggestions concerning its origin has been advanced. On the basis of their own and literature data the authors describe the pathogenesis of ST and of its main symptoms.

Adolescent↗
PubMed1985

Long-term results of open sternocleidomastoid tenotomy for idiopathic muscular torticollis.

At the end of their skeletal growth, we evaluated the cases of sixty-seven patients who had had an open tenotomy of the sternal and clavicular origins of the sternocleidomastoid muscle for idiopathic muscular torticollis. The average length of follow-up was 15.4 years, and the average age at the last follow-up was 23.9 years. The patients were divided into three groups according to their age at the time of operation. Group I consisted of patients who were operated on between the ages of five months and six years; Group II, of patients who were operated on between the ages of seven and eleven years; and Group III, of patients who were operated on when they were twelve years old or older. According to our method of evaluation, 37 per cent of the patients had a good, 45 per cent had a fair, and 18 per cent had a poor result. The patients in Group I had the best results and those in Group III, the worst. In general, the patient's age at operation, the duration of the disease, and the severity of the deformity before the operation had the major effects on both cosmetic and functional results.

Adolescent↗
PubMed1985

[Etiology, pathogenesis, clinical picture and treatment of spastic torticollis and other extrapyramidal hyperkinesis].

The history, clinical picture and non-specific parameters of the restorative process were studied in 28 patients with spastic torticollis and in 7 patients with other extrapyramidal hyperkineses (EH). It was found that one of the most frequent causes of these disorders is a chronic encephalitis or the infectious-allergic process in the brain with the predominant damage to a number of extrapyramidal formations. The most optimum and effective method of EH therapy is repeated courses of dexamethasone treatment in combination with antibiotics, B and C vitamins and vasodilating drugs. If there are any foci of infection, their preliminary sanation is necessary.

Adult↗
PubMed1979

[Electromyography in spastic torticollis].

The EMG characteristics of convulsive activity in the sternocleidomastoid muscle in spastic torticollis vary in different stages of the disease. At the onset of the disease, the bioelectric muscle activity which accomplishes an involuntary turn of the head is registered. Eventually, as the morbid areas of myopathosis are formed in the "active" muscles and muscles preventing an involuntary turn, the electrogenesis of the latter becomes dominating. It is assumed that at the basis of this phenomenon lies a lowering of the excitation threshold in the neuromotor apparatus in the respective group of muscles with an appearance of a peripheral subordinating factor.

Adult↗
PubMed1979

Acquired torticollis in eleven horses.

Case records of 11 horses with acquired torticollis during a 15-year period were reviewed. The cause was established in seven of eight cases and included cervical intervertebral disk protrusion, skull fracture, neurogenic atrophy, and dystrophic myodegeneration. The latter condition was considered to be the most likely cause in the three horses that recovered.

Animals↗
PubMed1979

[Aetiopathogenesis of scoliosis, hip dysplasia and torticollis in infancy (author's transl)].

The special risk of the newborn to acquire, skeletal deformities is based on the increased plasticity, intensity of growth and extrapyramidal activity of reflexes which influence each other. These 3 factors may lead to structural growth- and weight bearing deformities in the presence of shrinking contractures and a unilateral oblique habitual position of the trunk. Considering the "Seventh Syndrome" the dual pathogenesis of scoliosis in infancy is discussed from our present point of view (including scoliosis due to oblique body position - moulded baby syndrome - and its deterioration as against true idiopathic infantile or advanced juvenile scoliosis respectively. Similarly is discussed the relation of hip dysplasia due to oblique habitual trunk position in regard to hip dysplasia in connection with CDH as well as the habitual oblique position of the head as against true muscular torticollis.

Diagnosis, Differential↗
PubMed1977

[Long-term results of operation for congenital muscular torticollis (author's transl)].

Tenotomie of the sternocleidomastoid muscle seems to be an operation without complications. This impression is confirmed by the majority of reports, most of which however deal with early follow-up results. The basis of this paper is a follow-up of 100 patients, 37 years postoperatively and a review of the literature. There were several avoidable inter- and postoperative complications. Unadequate treatment was one reason for poor results. Good alternative to the cast postoperatively were offered by physiotherapy or the Schanz cotton wool bandage. The use of a cast was followed in a few cases by reversible plexus damage and decubitus ulcers of the head. On the whole the longterm results after torticollis operations were good. Scars and slight recurrence did not disturb the patients seriously. There was no correlation between age at operation and asymmetry of the face.

Adolescent↗
PubMedDate not supplied

[Effect of DOPA and haloperidol on experimental torticollis originating in the mesencephalon and its modulation by stimulation of the caudate nucleus].

Electrolytic injury to dopaminergic neurons of the mesencephalic tegmentum in cats produced a steady experimental torticollis (ET) with contralateral turning of the head and body. DOPA potentiated and haloperidol mostly reduced ET. Analogous changes were induced by electrical stimulation of the ipsi- and contralateral caudate nucleus, respectively. Stimulation of the contralateral nucleus coupled with haloperidol administration led to a more pronounced restriction of ET. Unexpectedly, the same result was obtained after DOPA administration coupled with stimulation of the ipsi-lateral caudate nucleus. It is suggested that pharmacological treatment of torsion diseases should be combined with physical treatment methods.

Animals↗
PubMed1983

Muscular torticollis. A modified surgical approach.

Since 1967 twelve children with muscular torticollis were treated at the Los Angeles Shriners Hospital for Crippled Children with a modified bipolar release of the sternocleidomastoid muscle. The results of the procedure were compared with the results in twenty-two other patients who had had either conservative treatment or other types of operations and who were seen between 1952 and 1981. The average follow-up was nine years (range, one to thirty-three years). Fourteen patients, most of them less than one year old, were treated non-operatively and had 86 per cent good or excellent results. The bipolar release and z-plasty was performed either when conservative treatment had failed or in older children who had had other operations, and it yielded 92 per cent good or excellent results. Only 15 per cent good and 77 per cent fair results were obtained when surgical procedures other than bipolar release were performed.

Child↗
PubMed1980

[Febrile acute torticollis (author's transl)].

Febrile acute torticollis in the child represents a special clinical picture. Of variable cause, it may be indicative of an inflammatory, infectious or dystrophic pathology affecting any of the anatomical structures of the neck. Treatment is quite clearly defined, and it may be a therapeutic emergency. All ENT specialists must be familiar with this since they are most likely to be the first physician to whom such a child is brought.

Acute Disease↗
PubMedDate not supplied

[Operations on the peripheral nervous system in the treatment of spasmodic torticollis].

The aetiopathogenesis of spasmodic torticollis has not yet been explained. The problem of surgical treatment selection is also at issue. The authors present own observations in 5 cases treated by operations on the peripheral nervous system. In 3 cases a very good therapeutic results was obtained, in 2 cases the results was not satisfactory. A characteristic fact was appearance of ultimate improvement only several months after the operation, similarly as it is observed after stereotactic operations. In the light of own observations and a survey of the literature the authors reach the conclusion that operations on the peripheral nervous system as the first stage of surgical treatment give good results in most cases.

Accessory Nerve↗
PubMed1980

[Correction of deformities in congenital torticollis in the postoperative period].

Congenital spastic torticollis was surgically treated in 98 children. An original orthopedic device was used in 31 children. A comparative analysis of the results depending on the kind of immobilization and means of correction in 79 children showed the device to provide good results and to shorten the time of the treatment.

Adolescent↗
PubMedDate not supplied

[Microvascular compression of the accessory nerve in torticollis spastica].

The paper deals with the pathogenesis of torticollis spastica and potential modes of their treatment. The findings indicate that changes in the root of nerve XI are essential in the pathogenesis of this abnormality. Despite comparatively small materials, much higher efficiency of micro-decompression of the accessory nerve is shown.

Accessory Nerve↗