[Etiology and pathogenesis of the muscular torticollis].
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We have investigated the electromyographic (EMG) and kinematic characteristics of horizontal arm extension movements in patients affected by idiopathic cervical dystonia (ICD) as well as in normal subjects. In spite of the lack of an overt dystonic involvement of the muscles acting at upper arm level, all these patients were considerably bradykinetic. Although the degree of bradykinesia observed was comparable to that previously reported for the body segment directly affected by this patholgy (21,15,8), the EMG analysis of the agonist muscles indicated a specific pathophysiological mechanism. In particular, the recruitment of the posterior deltoid (pD) in ICD patients was severely impaired within the initial phase (130 ms) of the movement. On the other hand, within the same time span, the activation of the mD, a muscle that plays a more important postural role than the pD, was not significantly different between patients and normal subjects. This reduced recruitment in the initial phase of the AG1 appears responsible of the slowness of voluntary movements.
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A young woman presented with complaints of reading difficulty. An examination revealed that the patient had Duane's Retraction Syndrome--Type III, which affected her right eye. We prescribed yoked prism base left and additional base-in prism for the right eye in a successful attempt to alleviate the patient's symptoms.
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