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PubMed2001

Bovine immunodeficiency virus in experimentally infected rabbit: tropism for lymphoid and nonlymphoid tissues.

The bovine immunodeficiency virus (BIV)/New Zealand (Oryctolagus cuniculus) rabbit model was used to study events that underlie the early and chronic stages of viral replication, routes and time course of viral dissemination and the distribution of the virus in the lymphoid. nonlymphoid and mucosa associated tissues. The results indicated that BIV, a lentivirus with genetic relatedness to the HIV, induced changes of clinical (anorexia, weight loss, muscular wasting, diarrhea, hypoalgesia, torticollis), immunological (recurrent T- and B-cell dysfunctions) and histopathological (lymphadenopathy, splenomegaly) nature that closely parallels those described for cat (Fly), monkey (SIV) and human (HIV) lentiviral diseases. These findings showing that BIV induces both splenomegaly and lymphadenopathy syndromes with associated fatal immune dysfunctions and the ability of the virus to replicate productively at the mucosal surfaces in rabbits, emphasize the importance of the BIV/rabbit system as a good small-animal model for the study of retrovirus-induced AIDS and offers the opportunity to evaluate prophylactic and therapeutic anti-retroviral agents of relevance to HIV-1 as well as the opportunity to study mechanisms of drug resistance phenomena.

Animals↗
PubMed2004

[Sub occipital Pott's disease: report of 8 cases].

Craniocervical Pott's disease remains exceptional, and may cause spinal instability and severe cervicomedullary complications. We report eight cases of tuberculous spondylodiscitis at the craniocervical junction revealed by signs of spinal cord compression, torticollis and dysphagia. The value of CT and MR imaging is discussed.

Adult↗
PubMed2003

Vertebrobasilar ischemia and spinal manipulation.

OBJECTIVE: To examine cerebral arterial blood flow in 2 patients exhibiting signs of vertebrobasilar arterial ischemia (VBI) before and after spinal manipulative therapy. CLINICAL FEATURES: Two patients had a repetitive/resting tremor, one from a spastic torticollis with the onset immediately after self-manipulation by the patient 6 months earlier, and the second one with a generalized resting tremor, hip clonus, dizziness, and presyncope. The diagnosis of vertebrobasilar ischemia was established by continuous wave Doppler ultrasound and physical examination. INTERVENTION AND OUTCOME: Nonrotary cervical manipulation and diversified technique to the thoracic spine were performed. In the first patient, the spastic tremor improved by 80%. The repeat Doppler performed 13 months later showed an improvement in the arterial flow in the right external carotid artery peak flow from 0.7 kHz to 1.75 kHz. In the second patient, the resting tremor diminished in 4 days, with the right common carotid artery peak systolic flow improving from 1.0 kHz to 1.9 kHz and the left vertebral artery flow improving from 0.175 kHz to 0.5 kHz. The symptoms of VBI and objective Doppler findings improved following spinal manipulation. Both cases had impaired vertebral arterial flow. CONCLUSION: Spinal manipulation may have a normalizing effect on the sympathetic nervous system, allowing for a change in vasospastic cerebral vascular arteries.

Adult↗
PubMed1999

The empty sella.

OBJECTIVE: To discuss the diagnostic imaging findings of an empty sella in a chiropractic patient with emphasis on magnetic resonance imaging (MRI) of normal and abnormal pituitary appearances. CLINICAL FEATURES: A 44-year-old woman started having headache, dizziness, nausea, vomiting, and diarrhea after an argument with her boyfriend. She had been treated for acute torticollis for three weeks when the new symptoms began. Consultation with an internist led to an MRI examination of the cerebellopontine angles to exclude an acoustic neuroma. The MRI demonstrated an enlarged empty sella. There was no history of pituitary tumor or other sellar disease. INTERVENTION AND OUTCOME: There was complete remission of the symptoms after 1 additional dizzy spell that occurred 3 days after the initial symptom. No intervention was performed, but the stress levels in her life had been reduced. CONCLUSION: An enlarged empty sella can be present without symptoms and can represent an incidental finding on radiography and MRI. However, an enlarged sella seen on lateral cervical spine radiographs should prompt further evaluation to rule out pituitary disease. The normal pituitary has a varied appearance and signal intensity on MRI depending on the patient's age and pregnancy status.

Adult↗
PubMed1987

Use of botulinum toxin in the treatment of one hundred patients with facial dyskinesias.

One hundred patients with involuntary eyelid and facial spasms resulting from essential blepharospasm, Meige syndrome, and hemifacial spasm continued to respond to repeated injections of botulinum toxin at expected time intervals during a 30-month period. This series of more than 372 injections done by one of us (JAM) supports the finding of earlier, smaller series that tolerance to the toxin does not develop. The drug had a greater duration of effect in patients with hemifacial spasm than in patients with blepharospasm; the duration of effect was 17.25 weeks in the former group and 12.6 weeks in the latter. Eighteen percent of patients required a higher than standard dose for a therapeutic response. Fourteen of 15 patients with lower facial spasms and one patient with torticollis had significant relief. Dry eye may be managed by titrating the lower lid dose.

Blepharospasm↗
PubMed2003

Bilateral sternocleidomastoid tumor of infancy.

The sternocleidomastoid tumor of infancy (STOI), also known as fibromatosis colli, presents as a firm well circumscribed mass within the sternocleidomastoid muscle (SCM) in infants of 1-8 weeks of age. Some of these lesions are associated with torticollis, facial and cranial asymmetry. Incidence of STOI is approximately 0.4% of live births and usually 90% of the patients will have a good prognosis if therapy is initiated and continued for the appropriate period of time. This paper presents two cases of bilateral involvement of STOI, which is very rare. The bilateral nature of the masses added to the uncertainty of the clinical diagnosis and the unusual features of these cases are discussed.

Fibroma↗
PubMed1996

A case of familial sternocleidomastoid tumor of infancy.

Sternocleidomastoid tumor of infancy (STOI) is a benign, firm, fibrous swelling predominantly involving the middle or inferior third of the sternocleidomastoid muscle. Patients may present simultaneously with, or progress to the development of, congenital, muscular torticollis (CMT) during childhood. This pseudotumor affects infants in their first few weeks of life with the vast majority showing complete regression over the ensuing few months. Multiple postulates have been presented as to the exact etiology of STOI; however, the cause is still unknown. Two siblings, both requiring vacuum extraction during delivery, presented at 4 weeks of age to the Children's Hospital of Philadelphia (CHOP) with STOI. The possible genetic predisposition of these siblings to develop STOI is hypothesized. Familial cases of CMT have been reported along with the possible genetic or peripartum factors that could play a role in its development. We reviewed these same mechanisms that could also predispose to familial STOI. Currently, magnetic resonance imaging is the diagnostic modality of choice. Fortunately, the majority of STOI responds to conservative measures with aggressive physical therapy, thus avoiding the need for operative intervention.

Diagnosis, Differential↗
PubMed1998

Internal jugular vein thrombosis in a child due to a 'pencil point injury' of the palate.

Penetrating trauma of the soft and hard palate are common in children and have been termed 'pencil point injuries.' Although such injuries are usually minor, the English literature has reported over 25 cases complicated by thrombosis of the internal carotid artery. We describe an unusual case of a 6 year old girl who presented with fever, cervical swelling and torticollis, following a pencil point injury. Physical examination and CT scan confirmed the diagnosis of internal jugular vein thrombosis (IJVT). The management of pencil point injuries and IJVT in children is reviewed and the possible mechanisms of IJVT in the case described here, are discussed.

Child↗
PubMed2001

Focal dystonia: current theories.

Dystonia is a syndrome characterised by abnormal involuntary sustained muscle contractions that often result in twisted and abnormal positions. Focal dystonia affects only a single body part with symptoms varying from permanent (e.g., torticollis) to task-specific (e.g., musician's cramp). The exact causes of focal dystonia have yet to be determined. Possible causative factors have been identified at all levels along the sensorimotor pathway, including anatomical constraints of the hand (musicians), abnormal co-contractions of the muscles due to reciprocal inhibition in the spinal cord, subcortical and cortical remapping, deficiencies in sensorimotor integration and perceptual deficits. A review of the current literature on these topics is provided with a special focus on musicians with focal dystonia. Also reviewed are current treatments of focal dystonia in musicians. On the basis of the currently available evidence, certain risk factors are identified for the development of task-specific focal dystonia, including number of practice hours, personality, genetic predisposition, performance factors and sensory effects. In addition, it is highlighted that dystonic movements occur predominantly in the context of perceptual-motor tasks involving emotions. When emotional and motor traces have become associated, they are difficult to change; it is suggested that this mechanism plays an important role in the preservation of dystonic symptoms.

Adult↗
PubMed2003

[Movement disorders and botulinum toxin in neurology].

Botulinum toxin has been a useful treatment in many movement disorders and more recently in other non-neurological motor dysfunctions for more than 15 years. Here, we review the various indications in neurology, mainly in the field of movement disorders. From 1973 to 2002, we searched the Medline database on this topic. We selected the most useful and relevant papers, with a special interest in dystonia. We summarized the results in the main indications (spasmodic torticollis, bleparospasm, hemifacial spasm) and in other manifestations such as writer's cramp, oromandibular dystonia, tremor, tics and myoclonus. We discuss the data of literature and compare them with the experience of the French movement disorders groups.

Anti-Dyskinesia Agents↗
PubMed2003

Investigation of several selected adjuvants regarding their efficacy and side effects for the production of a vaccine for parakeets to prevent a disease caused by a paramyxovirus type 3.

The infection with paramyxovirus type 3 (PMV-3) of parakeets can lead to severe illness in small psittacines (Neophema spp. and other parakeets) as well as in passerines (finches). The disease is characterized by acute or chronical pancreatitis and central nervous symptoms, such as torticollis as well as walking in circles and by high mortality rates in the affected flocks. As there is no licensed vaccine for psittacines available to prevent this disease. The aim of the following study was to find a suitable vaccine formulation for parakeets with inactivated PMV-3 and a well-tolerated and effective adjuvant. Seven adjuvants have been examined in ovo and in vivo regarding their efficacy and side effects. In these investigations, the classical Freund's complete Adjuvant (FCA) and Freund's incomplete Adjuvant (FICA) and Alhydrogel, but also the more recent developments TiterMax Gold, Specol, Gerbu Adjuvant 100, and Diluvac Forte have been used. Regarding its efficacy and side effects, the vaccine formulation "PMV-3/Specol" has been evaluated positively and can be recommended for the production of a PMV-3 vaccine for parakeets.

Adjuvants, Immunologic↗
PubMed1978

Closed condylotomy in the treatment of recurrent dislocation of the mandibular condyle.

Twenty-one patients 10-79 years of age were operated on for recurrent dislocation of the mandibular condyle using Kostecka's closed condylotomy method. The procedure alters the condyle position and will indirectly shorten the lateral pterygoid muscle, thus eliminating its pulling power to the condyle, even though it still functions. For the study, a late examination was performed with at least 1 year's follow-up. Seventeen patients were cured after unilateral or bilateral condylotomies, and two patients were asked to undergo a second operation on the opposite side. In normal cases any joint operated on was cured. Two cases suffering from congenital torticollis or disseminated sclerosis were felt to be unsuccessful. One exceptional case resulted in a pseudarthrosis, and was repaired by rib bone cartilage transplant. The method is the simplest and least traumatic when recurrent dislocation of the temporomandibular joint is treated surgically.

Adolescent↗
PubMed1998

Understanding and measurement of muscle tone as related to clinical muscle pain.

Measurable sources of muscle tension include viscoelastic tone, physiological contracture (neither of which involve motor unit action potentials), voluntary contraction, and muscle spasm (which we define as involuntary muscle contraction). The latter two depend on motor unit action potentials to generate the tension. Total muscle tension is most accurately measured as stiffness. Thixotropy of muscle is an ubiquitous and functionally important phenomenon that is not commonly recognized. A clinical pain condition associated with increased muscle tension is tension-type headache, which is largely muscular in origin; it is often caused by myofascial trigger points, but not by a pain-spasm-pain cycle, which is a physiologically and clinically untenable concept. Clinical conditions associated with painful muscle spasm include spasmodic torticollis, trismus, unnecessary muscle tension, nocturnal leg cramps, and stiff-man syndrome.

Biomechanical Phenomena↗
PubMed1999

The role of botulinus toxin type A in treatment--with special reference to children.

Although botulinum toxin A was first introduced to treat strabismus and blepherospasm it is now used in an increasing number of conditions, many in the field of pediatrics. Its action results from a prevention of the release of acetylcholine from nerve terminals. A number of studies recording the effects of the toxin in the treatment of spastic cerebral palsy are reviewed, and although these can be criticized, there seems to be no doubt that it can be of benefit. It is few side effects, but it may reveal an underlying weakness. Other disadvantages are its cost and the need for repeated injections. It can be used for the relief of rigidity, although the effects in the extrapyramidal form of cerebral palsy are not so dramatic. Also it can be beneficial in some forms of dystonia, rarely if this is generalized, but certainly if it is focal, and especially if there is accompanying pain. There are several conditions seen in children, such as strabismus, blepherospasm and tremors, in which this form of treatment will rarely be indicated; but they will be mentioned. An exception may be spasmodic torticollis during adolescence if it does not respond to other therapy, as it is so disabling. Botulinum toxin can be used to block the discharges from cholinergic sympathetic and parasympathetic terminals. Focal hyperhidrosis can be very distressing among older children, and the use of the toxin should sometimes be considered in this and other autonomic disorders.

Autonomic Nervous System Diseases↗
PubMed2004

Development of botulinum toxin therapy.

Justinius Kerner collected data on 230 cases of botulism in the 1820s, suggested the therapeutic use of toxin, and gave a remarkably complete and accurate description of clinical botulism: its symptoms, time course, and the physical findings that the tear fluid disappears, the skin is dry, the eye, gut, and somatic muscles are paralyzed, and mucus and saliva secretion is suppressed. These effects are the clinical targets of botulinum therapy today. Inspired by Drachman's use of toxin to safely paralyze the hind limb in chicks, we worked out the procedures for its safe medical application and licensure from 1972 to 1989, applying it first to correct strabismus, blepharospasm, leg muscle spasm, and torticollis. This list is now extended by others to well over 100 uses. For many years, blepharospasm patients returning for injection around the eyes and upper face would mention as a joke that they were "back to get the wrinkles out." Working in aesthetic dermatology and ophthalmology, Alistair and Jean Carruthers could envision the intentional cosmetic application of botulinum toxin, probably its greatest single use today.

Botulinum Toxins, Type A↗
PubMed2002

Group B streptococcal retropharyngeal cellulitis in a young infant: a case report and review of the literature.

The diagnosis of retropharyngeal cellulitis and abscess, although most common in children under 6 years of age, is often misdiagnosed in the newborn or early infancy period. The clinical signs of drooling, neck swelling, dysphagia, and torticollis may be absent or not easily identifiable. The following case report details a 2 1/2-month-old infant who presented with fever and irritability, and was subsequently diagnosed with group B streptococcal retropharyngeal cellulitis. Retropharyngeal cellulitis and abscess should be considered in the differential diagnosis of infants and young children who present with fever and irritability, particularly when lumbar puncture results are normal. This case also serves to highlight a rare manifestation of late-onset group B steptococcal disease.

Cellulitis↗
PubMed1993

Quinolizidine and piperidine alkaloid teratogens from poisonous plants and their mechanism of action in animals.

Quinolizidine and piperidine alkaloid teratogens from Lupinus, Conium, and Nicotiana genera have been identified as causes of birth defects in livestock induced by poisonous plants. Many defects now known to be related to poisonous plant ingestion were once thought to have a genetic origin. This supposition delayed diagnosis, reporting, and understanding of such birth defects, because breeders and producers feared the news would make it difficult to sell breeding stock. Defects caused by quinolizidine and piperidine teratogens include cleft palate and contracture-type skeletal defects such as arthrogryposis, scoliosis, torticollis, and kyphosis. Teratogens have been identified, differences in susceptibility to teratogenic compounds among livestock species have been elucidated, periods of gestation when specific types of birth defects occur have been determined, and information about mechanism of action has been developed.

Alkaloids↗
PubMed2000

[Sternocleidomastroid inflammatory pseudotumors of muscle in children].

PATIENTS AND METHODS: The files of 12 children presenting with a sternocleidomastoid tumor of infancy at the Timone Children's Hospital in Marseille between 1990 and 1999 were retrospectively studied. All of them underwent physical and ultrasonographic examination. RESULTS: The mass was firm, within the lower two-thirds of the sternocleidomastoid muscle. Ultrasonographic examination showed a soft tissue mass independent of the great vessels. Biopsy revealed a benign fibrous lesion. Eleven children were treated with stretching exercises and a surgical therapy was performed for one in whom physical therapy was unsuccessful. CONCLUSION: The sternocleidomastoid tumor of infancy is a lateral neck mass affecting children between the ages of two and four weeks. Most of the time it spontaneously resolves in four to eight months. It may be associated with congenital muscular torticollis and requires physical therapy. Surgery should be reserved for children who have failed with this treatment.

Female↗