Spasmodic Torticollis - Treatment

Treatment

There are several treatments for spasmodic torticollis, the most commonly used being botulinum toxin injections in the dystonic muscle of the neck. Other treatments include sensory trick, oral medications, and deep brain stimulation. Combinations of these treatments have been used to control spasmodic torticollis. In addition, selective surgical denervation of nerves triggering muscle contractions may offer relief from spasms, pain, and limit damage to the spine as a result of torqued posture. Spinal fibrosis (i.e., locking of spinal facets due to muscular contortion resulting in fused vertebrates) may occur rapidly. Therefore, it is important to seriously evaluate the option of surgical denervation as early as possible.

This suggests that the desynchronization of the frequency range is movement related. A sensory trick, also known as a geste antagoniste, is a common characteristic present in focal dystonias, most prevalently in cervical dystonia, however it has also been found in patients with blepharospasm. Sensory tricks offer only temporary and often partial relief of spasmodic torticollis. 74% of patients report only partial relief of spasmodic torticollis compared to 26% of complete relief of torticollis. The sensory trick must also be applied by the patient themselves. When the sensory trick is applied by an examiner, only 32% of patients report relief comparable to relief during self-application.

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