Spastic torticollis
The main element of the torticollis is the turning of the head. As a rule, at first the pathology is caused by an increased tone of the nodding muscle on one side, but after a while other muscles join. Spastic torticollis can be manifested by turning the head vertically to the side, tilting the head forward, tilting the head to the shoulder, or turning the head backwards. Spastic torticollis in adults can be accompanied by tremor and other dystonic syndromes, such as facial spasm, writing spasm, spastic dysphonia, and foot dystonia. Corrective gestures, such as putting the fingers of the other hand on the chin to turn the head, usually help patients reduce symptoms.
Exam. Patients with spastic torticollis undergo general clinical and neurological examination. In some cases, laboratory diagnostics (for example, a study of copper metabolism) and neuroimaging, for example, an MRI scan of the brain, are necessary.
Treatment. The gold standard for the treatment of spastic torticollis is botulinum therapy – injections of botulinum toxin type A drugs (Botox, Xeomin, Lantox, Dysport) into the corresponding muscles. Drug therapy may also be used.
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