What Is Spasmodic Torticollis?

Spastic torticollis is a type of dystonia that is restricted to the neck muscles. Intermittent or continuous involuntary contraction of the neck muscles causes the head and neck to be twisted, skewed, and the posture abnormal. Usually onset in 30 to 40 years old.

Basic Information

Visiting department

Neurology

Multiple groups

30 to 40 years old

Common locations

neck

Common causes

Intermittent or persistent involuntary contractions of the neck muscles

Common symptoms

Twisted, skewed head, abnormal posture

Causes of spastic torticollis

Most patients with spastic torticollis have an unknown etiology, and a few have a family history. The pathogenesis of spastic torticollis is not fully understood, and may be related to dysfunction of the basal nucleus, thalamus, and vestibular nerve.

Clinical manifestations of spastic torticollis

There are many clinical symptoms of spastic torticollis. The basic symptoms can be divided into four types: rotary type, lateral type, backward type, and forward flexion type. Some patients' clinical symptoms are mixed manifestations of multiple types. Patients are often accompanied by neck and shoulder pain, and some patients have depression or even depression. In general, symptoms worsen during exercise or emotional agitation, anxiety, relieved when quiet, and disappear during sleep.

Spastic torticollis

Head and neck magnetic resonance MRI and CT are generally required to rule out other diseases. EMG helps identify spasmodic muscles.

Diagnosis of spastic torticollis

According to medical history and physical examination, muscle groups with neck spasms and electromyography can diagnose the disease.

It needs to be distinguished from congenital muscular torticollis and atlantoaxial subluxation.

Congenital muscular torticollis

The disease is that the fetus during the birth of the sternocleidomastoid muscle is injured, bleeding, and then the injured sternocleidomastoid muscle gradually scars contracture, resulting in head and neck deviation. Symptoms are usually found before the baby begins to sit up. It is not difficult to distinguish from spastic torticollis.

2. Atlantoaxial subluxation

According to medical history, physical examination and electromyography, it is not difficult to distinguish it from spastic torticollis.

Spastic torticollis treatment

Drug treatment

Has a certain effect, but it is difficult to cure. Commonly used drugs are medopa, baclofen, diazepam, haloperidol and so on.

2. Botox injection treatment

It works, but the duration of effect is about 3-4 months, and patients need repeated injections to get long-term relief.

3. Surgical treatment

There are many surgical methods, the effectiveness is different, and there are corresponding risks.

4. Deep brain stimulation (DBS)

Safe and effective, but expensive.

Spastic torticollis prognosis

Spastic torticollis is a slow-progressive disease that stabilizes after a few years and generally cannot cause patient death by itself. However, the quality of life of patients is severely affected and extremely distressed, and some patients suffer from depression and suicide as a result. A few patients can heal themselves.