3,264 results on '"Torticollis"'
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2. Functional Movement Disorder; Importance of Proper Diagnosis and Treatment: A Case Report
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Hadi Shojaei and Taylor Wilkins
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Dystonia ,torticollis ,functional movement disorder ,psychogenic movement disorder ,Chronic pain ,Medicine - Abstract
Purpose: Dystonia is a common movement disorder, causing chronic pain, with a wide range of aetiologies. Delays in identification and initiation of effective treatment should be minimized to improve patient's pain and optimize the outcomes. This case report aims to underscore the successful treatment of chronic dystonia with the use of mood-modifying serotonin and norepinephrine reuptake inhibitors, and encourage clinicians to consider a diagnosis of functional (psychogenic) movement disorder in patients with dystonia that is refractory to usual treatment. Patients and methods: This case report describes a 40-year-old female who presented to a chronic pain clinic for pain related to primary dystonia with associated head tremor. Her symptoms were refractory to nearly a decade of quarterly Botulinum toxin injections. Based on careful evaluation of the patient’s history, a normal neurological examination, elevated GAD-7, PHQ-9 and IEQ scores, and unsuccessful symptom management with Botulinum toxin to-date, a diagnosis of functional movement disorder (FMD) was made. Low-dose Cymbalta was initiated. Results: The patient achieved near complete symptom remission and resolution of her chronic pain within 2 months, and achieved complete resolution by 2 years. Conclusion: A diagnosis of FMD should be considered in all patients with dystonia, but especially in patients who respond inadequately to Botulinum toxin injections or other rehabilitation therapies. The treatment of comorbid psychiatric conditions can result in substantial benefit, and remission, of dystonia due to FMD.
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- 2023
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3. Botulinum Toxin Injections to the Obliquus Capitis Inferioris Muscle for Dynamic Cervical Dystonia Improves Subjective Patient Outcomes
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Robin Anne Bessemer and Mandar Jog
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dystonia ,tremor ,botulinum toxin ,torticollis ,Medicine - Abstract
The obliquus capitis inferioris (OCI) muscle is a significant driver of cervical dystonia with torticaput movements and a no–no head tremor. Limited data are available on the efficacy of OCI injections on patient outcomes. Our study aims to determine whether the botulinum toxin injection into OCI improves subjective patient quality of life in those with dystonic head tremors. A retrospective chart review was performed for 25 patients receiving injections into the OCI for a dystonic head tremor at the London Movement Disorders Clinic between January 2020 and January 2022. Toronto Western Spasmodic Torticollis Scale-2 (TWSTRS-2) subscale scores for disability and pain, TWSTRS-PSYCH scores, and the global impression of severity were extracted. The average TWSTRS-2 disability subscale change was −2.8 points (p < 0.003). The average TWSTRS-2 pain subscale change was −4.6 points (p < 0.003). The average TWSTRS-PSYCH score prior to injection was 5.6. After injection, the average score was 3.7 (p < 0.004). The patient self-reported average global impression of severity before injection was 7.0; after this, it was 4.2 (p < 0.0003). The OCI injection showed significant improvement in retrospective patient self-reported outcomes; it should be considered early in the treatment plan for cervical dystonia with a no–no head tremor.
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- 2024
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4. Fibromatosis colli, an unusual neck mass: A case report
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Pin-Hua Chen, Chih-Chuan Hsu, and Hueng-Chuen Fan
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fibromatosis colli ,sternocleidomastoid muscle ,torticollis ,Medicine - Abstract
Fibromatosis colli (FC) is a condition of benign fibrous tissue proliferation on one side of the sternocleidomastoid (SCM) muscle leading to focal or diffuse enlargement of the neck and is often clinically associated with torticollis. Here, we report a case of a 2-month-old infant who was healthy except for a bulky neck mass on the left side of the SCM muscle. The patient was diagnosed with FC using sonography, which is a favored imaging tool because it can differentiate FC from other causes of neck masses. Physiotherapy can significantly improve the majority of FC cases.
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- 2023
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5. Congenital Muscular Torticollis—Current Understanding and Perinatal Risk Factors: A Retrospective Analysis
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Janusz Płomiński, Jolanta Olesińska, Anna Malwina Kamelska-Sadowska, Jacek Józef Nowakowski, and Katarzyna Zaborowska-Sapeta
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torticollis ,sternocleidomastoid muscle ,children ,perinatal risk factors ,Medicine - Abstract
Introduction: Congenital muscular torticollis (CMT) is an asymmetrical head position resulting from structural changes in the sternocleidomastoid (SCM) muscle that occurs early during a child’s development or due to perinatal trauma. Children with CMT exhibit a marked imbalance in tension between the SCMs. In a typical clinical picture, an ultrasound scan is performed to reveal characteristic lesions, such as tissue fibrosis or post-traumatic changes. An early diagnosis of CMT in newborns and the implementation of treatment offer the chance of a complete resolution. Torticollis treatment aims to restore the SCM’s normal function. Surgical treatment is performed when conservative methods fail to improve the patient’s condition. The indications that surgery is needed include a marked shortening of the SCM, persistent fibrosis in the muscle, constant head and facial asymmetry, and rotation or lateral flexion in the cervical spine restricted by >15°. Of all the newborn and infant anomalies, congenital torticollis is the third most common after hip dysplasia and equinovarus deformities. Some authors demonstrate that torticollis coexists with hip dysplasia. Aim: The aim of this study was to collect data on infants referred to paediatric rehabilitation and to identify the risk factors associated with CMT in this group of patients, as well as to assess demographic and clinical characteristics concerning risk factors. Materials and methods: The target population for this retrospective study consisted of 111 infants aged 0 to 5 months born in Poland and diagnosed with and undergoing treatment due to CMT. The following were determined: the relationship between the side of the CMT location and the type of delivery (caesarean section vs. vaginal), the relationship between the body weight at birth and the side of the CMT location, the relationship between the extent of SCM thickening and the type of delivery, and the incidence of CMT depending on the order of delivery. Results and conclusions: The data revealed that CMT is less common in female infants (n = 51, 46%) compared to male (n = 61, 54%) infants, in whom a greater birth weight was reported (p < 005). Seventy-six percent (76%) of the paediatric patients with CMT were the offspring of primipara mothers. More often, children born via vaginal delivery had left-sided torticollis with a more significant broadening of the SCM, as shown on ultrasound scans, than right-sided torticollis. Theories of torticollis development pathophysiology should be deepened and systematised, and further research is needed.
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- 2023
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6. Voluminous craniopharyngioma evolving since childhood revealed by a torticollis
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Ikram Damoune, Akioud Fatima, and Farida Ajdi
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craniopharyngioma ,stature-weight growth delay ,torticollis ,Medicine - Abstract
In case of a torticollis or a stature-weight growth delay in a child, it is always necessary to eliminate a cerebral tumor in the first place, especially a craniopharyngioma. We report the case of a 22-year-old patient with a large craniopharyngioma probably evolving since childhood and revealed by a torticollis associated with decreased visual acuity and a delayed growth and puberty.
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- 2022
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7. Ultrasound visualization of torsional anatomic changes in the neck: Applications to cervical rotational torticollis
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Filemon C Tan, Jeffrey A Strakowski, and Faye Y Chiou-Tan
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anatomy ,botulinum toxin ,cervical ,dystonia ,injection ,neck ,torsion ,torticollis ,ultrasound ,Orthopedic surgery ,RD701-811 ,Medicine - Abstract
Introduction: The objective of this paper is to demonstrate changes in the sonographic appearance of muscles in region of the neck with cervical movement from neutral anatomic position to right rotational torsion. Methods: Sonographic images were obtained in a 56-year-old healthy female. Muscles selected are common targets for botulinum toxin A injection in treatment for cervical dystonia. Sonographic images were obtained with the transducer placed over the muscle of interest with the neck in both anatomic-neutral and right-rotated positions. Cine loop video was also recorded at each site to track muscles throughout torsion. Results: The results show that in rotational torsion, (1) the brachial plexus becomes difficult to view due to anisotropy when examining the scalenes. The relationship between the anterior and middle scalenes and brachial plexus becomes less distinct with cervical rotation beyond neutral position. (2) The positional relationship of the sternocleidomastoid (SCM) and the ipsilateral splenius capitus is altered. (3) The jugular vein changes from collapsed to distended in the contralateral SCM view. (4) The position of the trapezius is not altered significantly. Conclusion: The sonographic appearance of soft tissue structures about the neck differs significantly with cervical movement from an anatomic neutral position to a position of right torsion. Knowledge of the dynamic positional changes of the muscles in this region in relation to each other, as well as the neurovascular structures, with cervical movement and torsion can potentially improve diagnostic assessment as well as accuracy of interventional procedures.
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- 2022
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8. Torticollis in Non-Syndromic Unicoronal Craniosynostosis Is Predominantly Ocular Related
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Emily T. C. Tan, Parinaz Rostamzad, Yasmin S. Esser, Mieke M. Pleumeekers, and Sjoukje E. Loudon
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non-syndromic unicoronal craniosynostosis ,torticollis ,prevalence ,ophthalmic features ,plagiocephaly ,Medicine - Abstract
(1) Background: Patients with unicoronal craniosynostosis (UCS) often show torticollis which can result from either an ocular cause or contraction of the sternocleidomastoid muscle. For clinicians, it is crucial to know the prevalence of ocular torticollis (OT) to ensure appropriate referral for treatment. Furthermore, associated ophthalmic features with OT in these patients are scarcely described. The aim of this study was to determine the prevalence of OT in non-syndromic UCS patients and investigate its associated ophthalmic features. (2) Methods: In this descriptive cross-sectional study medical records of non-syndromic UCS patients treated between 1994–2022 in one tertiary care hospital in The Netherlands were retrospectively reviewed. Collected data included: diagnosis and type of torticollis, binocular single vision (BSV), strabismus, ocular motility, alphabetical patterns, refractive error, and amblyopia. Patients were classified as OT, based on their ophthalmic and/or orthoptic diagnosis. Prevalence was determined with the 95% CI using the Clopper–Pearson exact test. Associations between OT and the ophthalmic features were determined using Chi-square or Fishers’ exact test and its effect size was calculated using Cramer’s V. (3) Results: In total, 146 patients were included, of whom 57 had torticollis. An ocular cause for the torticollis was found in 54 patients. The prevalence of OT was 37% (n = 146; 95% CI [0.292–0.454]). Significant associations were found between OT and strabismus (p < 0.001), ocular motility abnormalities (p < 0.001), alphabetical patterns (p < 0.001), and amblyopia (p = 0.002). BSV (p = 0.277) and refractive error (p = 1.0) were not significantly associated with OT. However, in OT the BSV was relatively poor (42.1%) and more frequently absent (26.3%) compared to the non-torticollis group (7% poor and 16.3% absent). In both groups, excyclotorsion was predominantly present (62.3%). (4) Conclusions: In 95% of cases, torticollis in UCS patients is ocular-related. Overall, one in three patients with UCS have OT. This study emphasizes the importance of a timely referral of all patients with UCS with torticollis to an orthoptist and/or ophthalmologist, specialized in diagnosing and treatment of OT, before considering physiotherapy.
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- 2023
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9. A Case of Torticollis in an 8-Month-Old Infant Caused by Posterior Fossa Arachnoid Cyst: An Important Entity for Differential Diagnosis
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John K. Yue, Taemin Oh, Kasey J. Han, Diana Chang, and Peter P. Sun
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arachnoid cyst ,differential diagnosis ,posterior fossa ,torticollis ,Medicine ,Pediatrics ,RJ1-570 - Abstract
Torticollis is a clinical diagnosis with heterogeneous causes. We present an unusual case of acquired torticollis in an 8-month-old female infant with a large cerebellopontine angle arachnoid cyst. Symptoms resolved after surgical fenestration. Non-traumatic acquired or new-onset torticollis requires brain imaging, and posterior fossa lesions are an important entity in the differential for pediatric clinicians.
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- 2021
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10. A Rare Cause of Torticollis in Children: Atlantoaxial Rotatory Subluxation
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Ebru Tayfun, Seda Yurdaor, Engin Ertek, Aylan Özgürer, Esra Türe, Eylem Şen, Berna Aktürk, and Aynur Karaca
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atlantoaxial rotatory subluxation ,children ,torticollis ,pediatric emergency ,atlantoaksiyel rotatuar subluksasyon ,çocuk ,tortikolis ,pediatrik acil ,Medicine - Abstract
Torticollis is one of the common causes of admission to the emergency department among children which can make parents worried. This could be related to many traumatic and non-traumatic conditions. One of the rare causes of acute onset of torticollis is atlantoaxial rotatory subluxation, which is characterized by limitation of neck rotation, increased pain by movement. It is generally associated with a past trauma history. Although it is known as a temporary and self-resolving condition, if it is not diagnosed earlier it may lead to severe rotational deformity of the cervical spine. Therefore, detecting certain causes and providing proper treatment are highly important. Physical examination and history are usually enough to make the diagnosis, yet cervical X-ray and computed tomography scan can be considered for indefinite cases. Even though treatment options depend on symptoms and the patient's general status, conservative approach with cervical collar and anti-inflammatory drugs are recommended as a first step. We would like to present our case, a 13 year-old girl who has been diagnosed with atlantoaxial rotatory subluxation in our clinic to increase awareness of this condition which is often misdiagnosed in children.
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- 2021
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11. CHEMODNERVATION FOR CERVICAL DYSTONIA: A CLINICAL REVIEW
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Muhammad Atif Ameer and Danish Bhatti
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cervical dystonia ,torticollis ,chemodenervation ,movement disorders ,botulinum toxins ,nerve block ,bont ,Medicine - Abstract
Cervical dystonia (CD) is a focal dystonia characterized by involuntary contractions of neck muscles that result in patterned movements and abnormal postures of the head and neck that have a directional quality. CD is the most common form of dystonia presenting to the movement disorders clinic. Botulinum toxin is an effective treatment for cervical dystonia. It has become the first-line treatment for cervical dystonia with a satisfactory relief of symptoms reported in more than 80% of the cases. Multiple small and large scale studies proven that fact and provided Class-A evidence for the benefit. However, 20% of the patients discontinue treatment due to adverse effects, treatment failure and other reasons. With the proper knowledge of toxins and the anatomy of the neck, much better results can be achieved with fewer and self-limiting adverse effects as compared to other modalities. However, the expert consensus recommendations are lacking to guide clinicians for optimal use of botulinum toxin for cervical dystonias. This paper discusses the different available treatments, botulinum injection techniques and the adverse effects involved with the procedure.
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- 2020
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12. Calcification of cervical intervertebral disc in a child: A case report and review of literature
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Marić Dušan, Milankov Vukadin, Lalić Ivica, Bumbaširević Marko, and Abazović Džihan
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calcification ,intervertebral disk ,neck pain ,torticollis ,Medicine - Abstract
Introduction. We report a case of calcification of a cervical intervertebral disk in a child. This is a rare condition, and has been described in about 400 cases worldwide. Children affected by it present with the onset of pain, muscle spasm, and the presence of calcification of a intervertebral disk on radiography. Our objective was to present a case of sudden onset of pain in the neck and torticollis. Case outline. In our case, the condition was diagnosed after trauma, presented with neck pain and spasm of the right sternocleidomastoid. Initial neck radiography was done, and after identifying the calcification in front of C4 and C5 vertebral bodies, CT analysis was conducted. When it was concluded that there is no compression on spine nerve roots, conservative course of treatment was followed. The child had full regression of symptoms after two weeks. Conclusion. Emergency personnel should bear in mind that, even though radiographical finding of a calcification shadow in front of the spine may raise concern, the nature of this disorder is benign in most cases, and responds very well to conservative treatment.
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- 2019
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13. Hyperkinetic Dysarthria with Spasmodic Torticollis
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Susmi Pani, Shruti Kabra, Shilpi Chakraborty, and Indranil Chatterjee
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Dysarthria ,Hyperkinetic ,Torticollis ,Spasmodic ,Speech Therapy ,Medicine ,Otorhinolaryngology ,RF1-547 - Abstract
Introduction Spasmodic Torticollis is a condition in which tonic or clonic spasm in the Sternocleidomastoid and Trapezius muscles, cause the head to be deviated to the right or left and has also been reported to disrupt speech production. Spasmodic Torticollis is a part of unknown etiology of Hyperkinetic Dysarthria. Case Report We report a case of 30 years old male diagnosed as Hyperkinetic Dysarthria who was treated with speech therapy and without Botulinum toxin. Post therapy status was recorded after 12 sessions (frequency twice a week) and it shows improvement in speech characteristics. Discussion Management of the patients with Hyperkinetic Dysarthria with Spasmodic Torticollis is a long term and often a lifelong process. Speech therapy is offered at intervals in order to maintain communicative competence. Reported studies suggest the use of Botulinum toxin, but in the present study treatment efficacy was proven without the use of Botulinum toxin.
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- 2020
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14. Airbag deployment induced paediatric cervical injury following a car accident
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Ali Akhaddar and Mohammed Bahi
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air bag injury ,cervical spine injury ,motor vehicle accident ,neck pain ,torticollis ,Medicine - Abstract
A 12-year-old girl was involved in a 50 km/h motor vehicle accident that resulted in the deployment of both airbags. She was a front seat passenger well restrained by a three-point seatbelt. The driver (his father) was uninjured but the patient complained of a stiff and painful neck. On arrival in the emergency room, she was alert and hemodynamically stable. Physical examination showed swelling and excoriation of the skin over the anterior cervical area and mandibular region (A). Neurological examination results were normal except for torticollis and neck pain. Cervical spine radiography showed no abnormality except the loss of cervical lordosis. She was admitted for observation and was discharged ten hours later with a cervical collar and symptomatic drugs. At 15-day follow-up visit, the patient had no neck pain, and the neurological examination finding was normal. Airbags drastically reduce both morbidity and mortality from crashes, but a wide range of injuries has been reported as a result of direct contact of hot gas with facial skin and energy transmitted directly from the airbag system to the child´s head and neck. This device may cause ocular and facial injuries, abdomen and chest trauma, upper extremity injuries, and cervical spine lesions especially in pediatric populations. All children below 12 years of age or less than 40 kg of weight must not occupy the front seat passenger. Airbags may induce injuries that vary from minor to fatalities whatever the impact velocities. Practitioners should be aware about lesions induced by airbag deployment.
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- 2020
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15. Cervical dystonia: pain relieving effects of botulinum toxin treatment
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Michał Marciniec, Anna Szczepańska-Szerej, and Konrad Rejdak
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cervical dystonia ,torticollis ,pain ,botulinum toxins ,Education ,Sports ,GV557-1198.995 ,Medicine - Abstract
Cervical dystonia (CD) is a third most common movement disorder characterized by sustained or intermittent muscle contractions causing abnormal movements and postures of head and neck. Physical, emotional, cognitive, and self-awareness aspects are also affected, so CD is currently considered to be a “network” disorder with the involvement of multiple brain regions and cellular mechanisms. Pain occurs in 54.6% to 88.9% of patients with CD and is the most disabling non-motor symptom which strongly attributes to the quality of life deterioration. The dystonia-related pain is also the main reason patients are looking for treatment. Despite the high prevalence only small number of studies develops this issue. Botulinum toxin (BoNT) is a safe, efficacious and first choice treatment for CD. Up to 90% of patients reports an improvement in pain and motor symptoms after BoNT injections, however above mentioned effects may be partially independent due to the earlier and longer pain relief compared to muscle relaxation. The results of current studies suggest analgesic effects of BoNT are related to not only the acting in the neuromuscular junction. The central processing of nociceptive stimuli is contributed to be the main effect of BoNT analgesic therapy. To date, evidence for the association between dystonia-related pain and BoNT treatment become more significant but is still lacking. Further research is needed to investigate above correlation and issue an unambiguous high-level recommendations of analgesic therapy in CD.
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- 2018
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16. Optimization of pain management in cervical dystonia
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Michał Marciniec, Anna Szczepańska-Szerej, Marcin Kulczyński, Klaudia Sapko, and Konrad Rejdak
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cervical dystonia ,torticollis ,pain ,botulinum toxins ,Education ,Sports ,GV557-1198.995 ,Medicine - Abstract
Cervical dystonia (CD) is the third most common movement disorder characterized by sustained or intermittent muscle contractions causing abnormal movements, postures, or both. Pain in the course of CD is a frequent symptom reported by the 54.6% - 88.9% of patients, which strongly affects the disability and quality of life, and is the most common reason patients are looking for treatment. Despite the main effect of botulinum toxin (BoNT) is muscle relaxation through the inhibition of the acetylcholine release at the neuromuscular junction, the analgesic effect of BoNT is probably attributed to the acting on central nervous system. Up to 20% of patients discontinue therapy due to treatment failure or adverse effects. Most poor responses are related to suboptimal treatment and a minority to immunoresistance which currently concerns only 0-2,5% of CD cases. In case of confirmed immunoresistance to BoNT-A standard therapy, the use of BoNT-B or alternative BoNT-A is recommended. The currently available management of improving the analgesic efficacy of first-line treatment in patients without immunoresistance includes: the eradication of BoNT adverse events, the determination of individual BoNT dosage, reviewing injections technique with electromyography or ultrasound guidance, the implementation of a rehabilitation program and the applying of the invasive or non-invasive brain stimulation methods. However, due to the lack of evidences from the large, randomized, controlled, clinical trials, an issuance of unambiguous recommendations remains difficult. Further studies on a poor response to BoNT injections and analgesic effects of above methods in the treatment of the CD-related pain are needed.
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- 2018
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17. Rare Concurrence of Congenital Muscular Torticollis and a Malignant Tumor in the Same Sternocleidomastoid Muscle
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Yul-Hyun Park, Chul-Ho Kim, Jang-Hee Kim, Jun-Eun Park, and Shin-Young Yim
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Torticollis ,Congenital torticollis ,Fibrosarcoma ,Magnetic resonance imaging ,Medicine - Abstract
While congenital muscular torticollis (CMT) can occur along with other conditions, such as clavicle fracture or brachial plexus injury, these conditions exist outside the sternocleidomastoid muscle (SCM). We present a rare case with concurrence of CMT and a malignant tumor inside the same SCM, along with serial clinical and radiological findings of the atypical features of CMT. The malignant tumor was in fact a low-grade fibromyxoid sarcoma. To the best of our knowledge, the current case is the first of a concurrent condition of CMT inside the SCM. This case suggests that concurrent conditions could exist either inside or outside the SCM with CMT. Therefore, a thorough evaluation of SCM is required when subjects with CMT display atypical features, such as the increase of mass or poor response to conservative therapy. In that case, appropriate imaging modalities, such as ultrasonogram or magnetic resonance imaging, are useful for differential diagnosis.
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- 2018
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18. Torticollis
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Agusnadi M. and Sjabaroeddin Loebis
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torticollis ,juvenile rheumatoid arthritis ,acetosal ,Medicine ,Pediatrics ,RJ1-570 - Abstract
We report a case of 12 years old girl with acquired torticollis caused by juvenile rheumatoid arthritis. The main complaint are the head inclined to the right and the pain of right neck. We established the working diagnosis based on the history and typical clinical pictures. After having physiotherapy and drug therapy with acetosal, the patient become beter with the head and neck is in normal condition again. The importance is to treat cases of tortocollis as soon as possible, before there is a contractire of the muscles of the neck.
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- 2018
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19. Henry Meige: The man and his understanding of dystonia, at the turn of the 19th to 20th century
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M.-H. Marion
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Male ,Dystonia ,congenital, hereditary, and neonatal diseases and abnormalities ,Movement Disorders ,Movement disorders ,Psychotherapist ,Tics ,Eponym ,Encephalitis lethargica ,Meige Syndrome ,Focal dystonia ,medicine.disease ,nervous system diseases ,Conversion Disorder ,Neurology ,otorhinolaryngologic diseases ,medicine ,Humans ,Neurology (clinical) ,Cervical dystonia ,medicine.symptom ,Psychology ,Torticollis - Abstract
Background Henry Meige (1866-1940), a French neurologist, the pupil of Charcot, is remembered for the eponym, the Meige syndrome, describing the clinical picture of craniocervical dystonia. This historical review highlights the controversies from his essay on “Le Juif Errant” (the Wandering Jew), and the evolution of his understanding of the movement disorders of the face and neck at the time of the encephalitis lethargica. Results His thesis reported 5 patients from Eastern Europe, presenting with functional neurological disorders following traumatic life experiences. He wrote with Feindel the first book on movement disorders “Les tics et leur traitement”. He pioneered the concept of focal dystonia and distinguished the facial median spasm as a dystonic movement disorder of the face. He highlighted the co-existence of psychopathology and the influence of the mental on tics and dystonia. He coined with Brissaud and Feindel the term “geste antagoniste” in cervical dystonia. He emphasized the importance of self-management and psycho-motor retraining for focal dystonia. Conclusion Meige made an invaluable contribution to our understanding of movement disorders, during his long medical career. The eponym Meige syndrome should be retained to describe an individual clinical entity.
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- 2022
20. A Rare Complication Following Adenotonsillectomy: Grisel's Syndrome
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Niyazi Altıntoprak, Kübra Murzoğlu Altıntoprak, Furkan Keskin, and Öner Çelik
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atlantoaxial subluxation ,grisel's syndrome ,torticollis ,Medicine - Abstract
The nontraumatic subluxation of the atlantoaxial joint, also called Grisel's syndrome, is a rarely seen phenomenon in the pediatric population after nasopharyngeal inflammation or otolaryngological surgery. The patients are usually between 5 and 12 years old, and there is no gender difference in occurrence. Grisel's syndrome should be considered in patients who have painful torticollis after an upper airway infection or otolaryngological surgery. The most important factor affecting the prognosis is early diagnosis and treatment. Early diagnosis not only allows for conservative treatment, but it also prevents permanent neck deformity and the development of severe neurological deficit and morbidity due to extensive surgical procedures. Otolaryngologists should be aware of this rare, but potentially serious, condition.
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- 2018
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21. Use of Botulinum Neurotoxin in Parkinson’s Disease: A Critical Appraisal
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Wolfgang H. Jost
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botulinum neurotoxin ,Parkinson’s disease ,sialorrhea ,blepharospasm ,torticollis ,tremor ,Medicine - Abstract
For well over 30 years, the botulinum neurotoxin (BoNT) has been used for a large number of indications, some of which however have not been licensed. Admittedly, approval varies in many countries and this permits a large spectrum for evaluation. Thus, BoNT is used for patients with Parkinson’s disease (PD) and other Parkinson’s syndromes (PS) in varying degrees of frequency. We have to distinguish between (1) indications that are either approved or (2) those not approved, (3) indications that might be a result of PS and (4) finally those which appear independent of PS. The most important indication for BoNT in PS patients is probably sialorrhea, for which approval has been granted in the majority of countries. Cervical dystonia is a frequent symptom in PS, with anterocollis as a specific entity. A further indication is blepharospasm in the different forms, especially the inhibition of eyelid opening in atypical PS. The use of BoNT in cases of camptocormia, the Pisa syndrome and neck rigidity is still a matter of debate. In dystonia of the extremities BoNT can be recommended, especially in dystonia of the feet. One well-known indication, for which however sufficient data are still lacking, involves treating tremor with BoNT. As to autonomic symptoms: Focal hyperhidrosis and detrusor hyperactivity can be mentioned, in this last case BoNT has already been approved. A number of further but rare indications such as freezing-of-gait, dyskinesia, and dysphagia will be discussed and evaluated.
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- 2021
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22. Analiza skuteczności terapeutycznej metody MDT McKenzie zastosowanej w leczeniu zespołu zaburzeń strukturalnych w odcinku szyjnym kręgosłupa u 26-letniego mężczyzny – opis przypadku = Analysis of therapeutic efficacy of MDT McKenzie method used in the treatment of cervical spine structural disorders in a 26-year-old man - a case report
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Piotr Porzych, Małgorzata Pyskir, Dorota Ratuszek-Sadowska, Maciej Dzierżanowski, Ewa Trela, Krystyna Nowacka, and Magdalena Hagner-Derengowska
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kręcz karku ,terapia mechaniczna ,mcs zebris ,torticollis ,mechanical treatment ,mcs zebris. ,Education ,Sports ,GV557-1198.995 ,Medicine - Abstract
Porzych Piotr, Pyskir Małgorzata, Ratuszek-Sadowska Dorota, Dzierżanowski Maciej, Trela Ewa, Nowacka Krystyna, Hagner‑Derengowska Magdalena. Analiza skuteczności terapeutycznej metody MDT McKenzie zastosowanej w leczeniu zespołu zaburzeń strukturalnych w odcinku szyjnym kręgosłupa u 26-letniego mężczyzny – opis przypadku = Analysis of therapeutic efficacy of MDT McKenzie method used in the treatment of cervical spine structural disorders in a 26-year-old man - a case report. Journal of Education, Health and Sport. 2016;6(6):491-504. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.56367 http://ojs.ukw.edu.pl/index.php/johs/article/view/3637 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.05.2016. Revised 25.05.2016. Accepted: 16.06.2016. Analiza skuteczności terapeutycznej metody MDT McKenzie zastosowanej w leczeniu zespołu zaburzeń strukturalnych w odcinku szyjnym kręgosłupa u 26-letniego mężczyzny – opis przypadku Analysis of therapeutic efficacy of MDT McKenzie method used in the treatment of cervical spine structural disorders in a 26-year-old man - a case report Piotr Porzych1, Małgorzata Pyskir1, Dorota Ratuszek-Sadowska1, Maciej Dzierżanowski2, Ewa Trela1, Krystyna Nowacka1, Magdalena Hagner‑Derengowska3,4 1. Katedra i Klinika Rehabilitacji, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu 2. Katedra Fizjoterapii, Zakład Terapii Manualnej, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu 3. Bydgoska Szkoła Wyższa w Bydgoszczy 4. Katedra Neuropsychologii Klinicznej, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu Streszczenie Bóle występujące w obrębie szyi są zjawiskiem powszechnym. Wielogodzinne, wymuszone pozycje statyczne związane z pracą zawodową czy procesem edukacyjnym doprowadzają do przeciążeń kręgosłupa. Konsekwencją przeciążeń są zaburzenia funkcji kręgosłupa oraz zmiany strukturalne tkanek występujących w jego okolicy. Zmianom tym często towarzyszy ból. Złożona biomechanika kręgosłupa oraz różnorodność tkanek funkcjonalnie z nim związanych, stanowi istotny problem diagnostyczny. Metoda McKenzie poprzez opracowany model badania oparty na wywiadzie i badaniu przedmiotowym, pozwala wyodrębnić pacjentów o jednorodnym zaburzeniu narządu ruchu. Na jego podstawie zdiagnozować można mechaniczne źródło pochodzenia objawów oraz określić strukturę, która je generuje. W pracy opisano przypadek 26-letniego mężczyzny z bólem karku i kręczem prawostronnym, który został poddany terapii mechanicznej, poprzedzonej diagnozowaniem mechanicznym, w wyniku którego stwierdzono wystąpienie zespołu zaburzeń strukturalnych. Słowa kluczowe: kręcz karku, terapia mechaniczna, MCS Zebris. Abstract Pain occurring in the neck are common phenomenon. Forced, static and lasting many hours positions associated with work or educational process lead to overloading of the spine. Disorders of the spine function and structural changes of adjoining issue are the consequence of overloading. These changes are often associated by pain. The highly complicated spine biomechanics and a variety of functionally related tissues are an important diagnostic problem. McKenzie method allows to specify patients with homogeneous musculoskeletal disorder through elaborated diagnostic procedure based on an interview and physical examination. Mechanical cause of symptoms and structure that generates it can be identify based on it. This paper describes the case of 26-year-old man with neck pain and right torticollis, which has been submited to a mechanical treatment, preceded by a mechanical diagnosis, which concluded the complex of structural disorders. Key words: torticollis, mechanical treatment, MCS Zebris.
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23. Torticollis in childhood—a practical guide for initial assessment
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Dominic Thompson and Ido Ben Zvi
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medicine.medical_specialty ,Specialist referral ,business.industry ,media_common.quotation_subject ,Time critical ,medicine.disease ,Secondary care ,Presentation ,Pediatrics, Perinatology and Child Health ,Sternomastoid tumour ,medicine ,Cervical dystonia ,Intensive care medicine ,business ,Torticollis ,media_common - Abstract
Torticollis is encountered often in the paediatric setting and should be considered a presenting symptom, rather than a diagnosis. Aetiologies of torticollis are numerous, and the nomenclature describing underlying diagnosis can be confusing. Furthermore, children with torticollis typically present in the first instance to primary or secondary care rather than to the subspecialist. These factors can contribute to erroneous treatment of this patient-group which could be time critical in some instances. In this review, we discuss the common causes for torticollis and propose a simple clinical assessment tool and early management scheme that will assist in the differential-diagnosis and treatment pathway of this challenging condition.Conclusion: Torticollis can be the initial presentation of various conditions. The diagnosis and management tools provided in this article can aid in guiding paediatricians as to the correct initial management, imaging, and specialist referral. What is Known: • Torticollis in childhood is a very common presenting symptom with numerous aetiologies. • Management is complex, requires multiple clinical and imaging examinations, and is usually performed by non-specialized professionals. What is New: • A new, simple clinical-assessment tool under the acronym PINCH designed to aid paediatric general practitioners in diagnosing correctly the aetiology of torticollis. • A practical management scheme to aid in the treatment pathway of children with torticollis.
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- 2021
24. Demographics of Positional Plagiocephaly and Brachycephaly; Risk Factors and Treatment
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Michelle Marlena Wilhelmina Feijen, Rene Remmelt Willie Johan van der Hulst, Cas van Cruchten, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Plastische Chirurgie (PLC), MUMC+: MA Plastische Chirurgie (3), MUMC+: MA Plastische Chirurgie (9), MUMC+: MA AIOS Plastische Chirurgie (9), and RS: NUTRIM - R2 - Liver and digestive health
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Pediatrics ,medicine.medical_specialty ,Demographics ,Plagiocephaly ,BIRTH ,Birth weight ,INFANTS ,CHILDREN ,DIAGNOSIS ,Craniosynostoses ,MOLDING HELMET THERAPY ,Risk Factors ,mental disorders ,medicine ,Humans ,physical therapy ,Family history ,Child ,Positional plagiocephaly ,Plagiocephaly, Nonsynostotic ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant ,General Medicine ,medicine.disease ,PREVALENCE ,Treatment Outcome ,Otorhinolaryngology ,ASYMMETRY ,SKULL ,Helmet therapy ,Head Protective Devices ,Surgery ,positional cranial deformation ,positional plagiocephaly ,business ,Brachycephaly ,Psychosocial ,positional brachycephaly ,HEAD SHAPE ,Torticollis - Abstract
In the last 3 decades, the incidence of positional cranial deformations in infants, such as positional plagiocephaly and positional brachycephaly, has increased. The deviating shape often causes parental concern for the later psychosocial wellbeing of the child. Treatment options are nonoperative, varying from positional change to helmet therapy, of which the effect has often been debated. Multiple risk factors have been associated with an increased risk on the development of these deformations. The goal of this study was to assess the impact of known risk factors on the type and severity of resulting positional cranial deformation.Parents were asked to fill out a questionnaire regarding the presence of risk factors, such as gender, age, pregnancy duration, method of delivery and reasons for atypical deliveries, breech position, birth weight, developmental status, positional preference, family history, number of siblings, and torticollis presence. Treatment methods were documented and plagiocephalometry was used to measure the cranial proportions. All children were invited to participate in short-term follow-up. The significance of the risk factors and the effect of different kinds of therapy are discussed. Although no significant correlation was found between severity and risk factors, some risk factors could be correlated with the kind of positional cranial deformation. Of the different therapies, helmet therapy had a significant impact on the reduction of positional plagiocephaly.
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- 2021
25. Overview of DaxibotulinumtoxinA for Injection: A Novel Formulation of Botulinum Toxin Type A
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Joely Kaufman, Nowell Solish, Conor J. Gallagher, Roman G. Rubio, Todd M. Gross, and Jean Carruthers
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Clinical Trials as Topic ,Dose-Response Relationship, Drug ,business.industry ,Spasmodic Torticollis ,Leading Article ,Hydrogen-Ion Concentration ,medicine.disease ,Skin Aging ,Pharmacotherapy ,Symptom relief ,Neuromuscular Agents ,Median time ,Anesthesia ,Delayed-Action Preparations ,medicine ,Neurotoxin ,Humans ,Pharmacology (medical) ,Cervical dystonia ,Botulinum Toxins, Type A ,Duration of effect ,business ,Peptides ,Torticollis ,Botulinum toxin type - Abstract
Botulinum toxin type A (BoNTA) products are widely used for therapeutic and aesthetic indications, but there is a need for longer-lasting treatments that maintain symptom relief between injections and reduce the frequency of re-treatment. DaxibotulinumtoxinA for Injection (DAXI) is a novel BoNTA product containing highly purified 150-kDa core neurotoxin and is the first to be formulated with a proprietary stabilizing excipient peptide (RTP004) instead of human serum albumin. The positively charged RTP004 has been shown to enhance binding of the neurotoxin to neuronal surfaces, which may enhance the likelihood of neurotoxin internalization. DAXI produces robust, extended efficacy across both aesthetic and therapeutic indications. In an extensive glabellar lines clinical program, DAXI showed a high degree of efficacy, a consistent median time to loss of none or mild glabellar line severity of 24 weeks, and median time until return to baseline of up to 28 weeks. In adults with cervical dystonia, DAXI at 125 U and 250 U significantly improved Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) total scores, with a median duration of efficacy of 24 and 20 weeks, respectively, which compares favorably with the 12–14 weeks’ duration reported for approved BoNTA products. Overall, DAXI was well tolerated, and the consistent extended duration of effect suggests that DAXI has the potential to improve the management of both aesthetic and therapeutic conditions., Plain Language Summary Botulinum toxin is used to block the nerve signals that cause muscles to contract. Products containing botulinum toxin are commonly given by injection to treat muscle spasms (such as cervical dystonia, a painful condition where the neck muscles contract involuntarily) and for cosmetic treatment of frown lines. However, the effects of the currently approved botulinum toxin products typically wear off about 3–4 months after injection and so the injections must be repeated regularly. A new product called DAXI (DaxibotulinumtoxinA for Injection) has been developed. In this product, the botulinum toxin is formulated with a unique protein (called RTP004) that has been designed to help deliver the botulinum toxin to the nerve cells. Research suggests that the RTP004 protein in DAXI adheres the botulinum toxin to the nerves close to the injection site, potentially making its effect last longer. To date, DAXI has been studied in over 3800 patients. The studies have shown that DAXI is effective for treating neck spasms (cervical dystonia) and for reducing the appearance of frown lines. Importantly, the effects of DAXI lasted up to 6 months, which is longer than seen with other botulinum toxin products. The side effects seen with DAXI are consistent in nature and frequency with those seen with other botulinum toxin products. These findings suggest that DAXI can improve both medical and cosmetic treatments due to its longer-lasting effect.
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- 2021
26. Torticollis as an Initial Manifestation of a Seronegative Demyelinating Disorder in a Child: A Case Report
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Yellanthoor Ramesh Bhat, Lakshmikanth Halegubbi Karegowda, and Sandesh Kini
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Pediatrics ,medicine.medical_specialty ,business.industry ,Multiple sclerosis ,medicine.disease ,Cerebrospinal fluid ,Neuroimaging ,Methylprednisolone ,Pediatrics, Perinatology and Child Health ,medicine ,Demyelinating disease ,Neurology (clinical) ,Demyelinating Disorder ,business ,medicine.drug ,Torticollis - Abstract
Torticollis refers to a condition in which the head is persistently tilted to one side, sometimes associated with pain. Torticollis in a child can be congenital or acquired. Torticollis as an initial manifestation of an underlying demyelinating syndrome is quite rare in children. Here, we report a 7-year-old girl who presented with persistent torticollis. Neuroimaging of the brain revealed features of a demyelinating disease. Further studies did not show any evidence of multiple sclerosis. Cerebrospinal fluid was negative for antiaquaporin-4 antibodies, antimyelin oligodendrocyte glycoprotein antibodies, and oligoclonal bands. A seronegative demyelinating disorder was considered. She was treated with pulsed methylprednisolone therapy. She responded well to steroids with no progression of illness during follow-up. Torticollis was partially improved.
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- 2021
27. The Impact of Surgical Correction in Changing Morphometric Dimensions of Craniofacial Deformities and Facial Asymmetry in Congenital Muscular Torticollis: An Otolaryngologists Perspective
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Sharad Hernot, A. K. Pandey, Tripti Maithani, Kanika Arora, and Arvind Mamgain
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Orthodontics ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Tenotomy ,medicine.disease ,Otorhinolaryngology ,Congenital muscular torticollis ,Deformity ,medicine ,Harmonic scalpel ,Surgery ,medicine.symptom ,Craniofacial ,business ,Facial symmetry ,Torticollis - Abstract
To evaluate the synergistic occurrence of facial asymmetry and craniofacial deformities in cases of Congenital muscular torticollis (CMT) and to assess the outcome of surgical correction on these deformities. Twenty-three cases of CMT presenting in ENT OPD from January 2015 to December 2019, 9 cases requiring surgical intervention were included. Facial asymmetry and craniofacial deformities were evaluated and quantified by measuring gaze angle, translational deformity and orbito-alar distance. All cases underwent a bipolar tenotomy using harmonic scalpel. In all cases on comparison with preoperative status there was significant improvement (p
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- 2021
28. Dopaminergic and serotonergic alterations in plasma in three groups of dystonia patients
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Martijn van Faassen, Marina A. J. Tijssen, Ingrid H. Hof, Tom J. de Koning, Anouk Kuiper, Ido P. Kema, Elze R. Timmers, Marenka Smit, K. E. Niezen-Koning, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Movement Disorder (MD), and Center for Liver, Digestive and Metabolic Diseases (CLDM)
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Adult ,Male ,medicine.medical_specialty ,Levodopa ,Serotonin ,Adolescent ,Dopamine ,Motor Activity ,Serotonergic ,Young Adult ,Internal medicine ,otorhinolaryngologic diseases ,Medicine ,Humans ,Cervical dystonia ,Child ,Torticollis ,Aged ,Dystonia ,Aged, 80 and over ,business.industry ,Dopaminergic ,Middle Aged ,medicine.disease ,nervous system diseases ,Endocrinology ,Monoamine neurotransmitter ,Neurology ,Dystonic Disorders ,Case-Control Studies ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,medicine.drug - Abstract
INTRODUCTION: In dystonia, dopaminergic alterations are considered to be responsible for the motor symptoms. Recent attention for the highly prevalent non-motor symptoms suggest also a role for serotonin in the pathophysiology. In this study we investigated the dopaminergic, serotonergic and noradrenergic metabolism in blood samples of dystonia patients and its relation with (non-)motor manifestations.METHODS: Concentrations of metabolites of dopaminergic, serotonergic and noradrenergic pathways were measured in platelet-rich plasma in 41 myoclonus-dystonia (M-D), 25 dopa-responsive dystonia (DRD), 50 cervical dystonia (CD) patients and 55 healthy individuals. (Non-)motor symptoms were assessed using validated instruments, and correlated with concentrations of metabolites.RESULTS: A significantly higher concentration of 3-methoxytyramine (0.03 vs. 0.02 nmol/L, p < 0.01), a metabolite of dopamine, and a reduced concentration of tryptophan (50 vs. 53 μmol/L, p = 0.03), the precursor of serotonin was found in dystonia patients compared to controls. The dopamine/levodopa ratio was higher in CD patients compared to other dystonia groups (p < 0.01). Surprisingly, relatively high concentrations of levodopa were found in the untreated DRD patients. Low concentrations of levodopa were associated with severity of dystonia (rs = -0.3, p < 0.01), depression (rs = -0.3, p < 0.01) and fatigue (rs = -0.2, p = 0.04).CONCLUSION: This study shows alterations in the dopaminergic and serotonergic metabolism of patients with dystonia, with dystonia subtype specific changes. Low concentrations of levodopa, but not of serotonergic metabolites, were associated with both motor and non-motor symptoms. Further insight into the dopaminergic and serotonergic systems in dystonia with a special attention to the kinetics of enzymes involved in these pathways, might lead to better treatment options.
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- 2021
29. Pain in cervical dystonia: mechanisms, assessment and treatment
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Lorraine Cuffe, Benjamin Regnault, Raymond L. Rosales, and Richard M Trosch
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medicine.medical_specialty ,Pain ,Chemodenervation ,law.invention ,Physical medicine and rehabilitation ,Randomized controlled trial ,law ,Basal ganglia ,Epidemiology ,medicine ,Humans ,Disabled Persons ,Pharmacology (medical) ,Cervical dystonia ,Botulinum Toxins, Type A ,Social isolation ,Torticollis ,business.industry ,General Neuroscience ,medicine.disease ,Botulinum toxin ,Nociception ,Neurology (clinical) ,medicine.symptom ,business ,medicine.drug - Abstract
Introduction In patients with cervical dystonia (CD), pain is a major contributor to disability and social isolation and is often the main reason patients seek treatment. Surveys evaluating patient perceptions of their CD symptoms consistently highlight pain as a troublesome and disabling feature of their condition with significant impact on daily life and work. Areas covered In this article, the authors review the epidemiology, assessment, possible mechanisms and treatment of pain in CD, including a meta-analysis of randomized controlled trial data with abobotulinumtoxinA. Expert opinion Mechanisms of pain in CD may be muscle-based and non-muscle based. Accumulating evidence suggests that non-muscle-based mechanisms (such as abnormal transmission and processing of nociceptive stimuli, dysfunction of descending pain inhibitory pathways as well as structural and network changes in the basal ganglia, cortex and other areas) may also contribute to pain in CD alongside prolonged muscle contraction. Chemodenervation with botulinum toxin is considered the first-line treatment for CD. Treatment with botulinum toxin is usually effective, but optimization of the injection parameters should include consideration of pain as a core symptom in addition to the motor problems.
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- 2021
30. Acquired cervical scoliosis in two dogs with inflammatory central nervous system disease
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Joe Fenn, Lydia Poad, and Steven De Decker
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Pathology ,medicine.medical_specialty ,Ataxia ,Veterinary medicine ,Case Report ,Case Reports ,meningomyelitis of unknown etiology ,Central nervous system disease ,Lesion ,Cerebrospinal fluid ,SF600-1100 ,medicine ,Pleocytosis ,General Veterinary ,business.industry ,torticollis ,spinal cord ,gray matter ,medicine.disease ,Spinal cord ,steroid‐responsive meningitis‐arteritis ,medicine.anatomical_structure ,Neurology ,Prednisolone ,SMALL ANIMAL ,medicine.symptom ,business ,Syringomyelia ,medicine.drug - Abstract
Acquired cervical scoliosis previously has been reported in dogs as a clinical sign associated with Chiari‐like malformation and syringomyelia but has not been described with inflammatory central nervous system disease. A 9‐month‐old Flat‐Coated Retriever was presented with an acute onset of cervical scoliosis with no other neurological deficits. Magnetic resonance imaging identified a focal, poorly defined intramedullary lesion within the cranial cervical spinal cord. Cerebrospinal fluid (CSF) analysis indicated mononuclear pleocytosis consistent with a diagnosis of meningomyelitis of unknown etiology. A second dog, a 3‐year‐old female spayed German Shepherd, developed an acute onset of cervical scoliosis with mild generalized proprioceptive ataxia 2 months after commencing immunosuppressive corticosteroid treatment for presumed steroid‐responsive meningitis‐arteritis. Magnetic resonance imaging at the time of diagnosis disclosed a similar intramedullary lesion within the cranial cervical spinal cord, with a neutrophilic pleocytosis on CSF analysis. Both dogs were treated with immunosuppressive dosages of prednisolone, along with cytosine arabinoside in the first dog, with resolution of cervical scoliosis seen in both. To our knowledge, this is the first report of acute onset acquired, reversible cervical scoliosis in dogs with presumed immune‐mediated meningomyelitis.
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- 2021
31. Hyper- and hypo-connectivity in sensorimotor network of drug-naïve patients with cervical dystonia
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Huizi Ma, Ling-Yan Ma, Tao Feng, and Zhi-Jiang Wang
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Adult ,Male ,Oncology ,medicine.medical_specialty ,Spasmodic Torticollis ,Somatosensory system ,Severity of Illness Index ,Internal medicine ,medicine ,Humans ,Cervical dystonia ,Correlation of Data ,Torticollis ,medicine.diagnostic_test ,Resting state fMRI ,business.industry ,Postcentral gyrus ,Somatosensory Cortex ,Middle Aged ,Focal dystonia ,medicine.disease ,Magnetic Resonance Imaging ,Drug-naïve ,Neurology ,Case-Control Studies ,Female ,Sensorimotor Cortex ,Neurology (clinical) ,Nerve Net ,Psychomotor Disorders ,Geriatrics and Gerontology ,Functional magnetic resonance imaging ,business ,medicine.drug - Abstract
Background Cervical dystonia (CD) is the most common form of focal dystonia with involuntary movements and postures of the head. The pathogenesis and neural mechanisms underlying CD have not been fully elucidated. Methods Twenty-seven newly drug-naive patients with CD and 21 healthy controls (HCs) were recruited with clinical assessment and resting-state functional magnetic resonance imaging (rs-fMRI) scanning. Severity of CD was measured by Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Tsui scores. Whole-brain voxel-wise intrinsic connectivity (IC) and seed-based functional connectivity (FC) analyses were performed for detection of changes in the CD group relative to HCs, controlling for age, gender, and global time series correlation, followed by correlation analyses of IC, seed-based FC and clinically relevant features, respectively. Results In comparison with HCs, CD patients showed significantly increased IC measurement in the anterior part of the left supramarginal gyrus and extended to the inferior left postcentral gyrus (AL-SMG/IL-PCG). With this cluster as a seed, decreased FC was found in the right precentral and postcentral gyrus. Moreover, the regional IC value in the AL-SMG/IL-PCG was significantly positively correlated with TWSTRS-1 (severity) score, and significantly negatively correlated with the associated seed-based FC strength. Conclusions Our results showed signs of both hyper- and hypo-connectivity in bilateral regions of the sensorimotor network related to CD. The imbalance of functional connectivity (both hyper- and hypo-) may hint both overloading and disrupted somatosensory or sensorimotor integration dysfunction within the sensorimotor network underlying the pathophysiology of CD, thus providing a network target for future therapies.
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- 2021
32. Improvement of head and neck range of motion induced by chronic pallidal deep brain stimulation for cervical dystonia
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Hansjoerg Baezner, Christian Blahak, Joachim K. Krauss, Assel Saryyeva, and Marc E. Wolf
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medicine.medical_specialty ,Deep brain stimulation ,Neurology ,Deep Brain Stimulation ,medicine.medical_treatment ,Electromyography ,Globus Pallidus ,Humans ,Medicine ,Cervical dystonia ,Range of Motion, Articular ,Head and neck ,Torticollis ,Biological Psychiatry ,medicine.diagnostic_test ,business.industry ,Ultrasound ,medicine.disease ,Psychiatry and Mental health ,Treatment Outcome ,Coronal plane ,Neurology (clinical) ,business ,Range of motion ,Nuclear medicine - Abstract
Deep brain stimulation (DBS) of the globus pallidus internus (GPi) has become an accepted treatment for severe cervical dystonia (CD). Assessment of therapeutic efficacy of DBS mostly focused on head position at rest but hardly on limitations of head and neck mobility, which represent a functionally important impairment in CD. We aimed to determine prospectively head and neck range of motion (ROM) preoperatively and during chronic bilateral GPi DBS in a series of 11 patients with idiopathic CD or segmental dystonia with prominent CD using a computerized motion analysis. Maximum horizontal rotation of the head in the transverse plane and lateral inclination in the frontal plane were measured preoperatively and at a median of 7 months of chronic GPi DBS, using an ultrasound-based three-dimensional measuring system combined with surface electromyography of cervical muscles. Horizontal rotation of the head increased from 78.8° ± 31.5° (mean ± SD) preoperatively to 100.7° ± 24.7° with GPi DBS (p
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- 2021
33. Study of the peculiarities of the osteopathic status in patients with planovalgus deformity of the feet in combination with a history of placement torticollis and without such a combination
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030222 orthopedics ,medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,Somatic dysfunction ,General Medicine ,medicine.disease ,030205 complementary & alternative medicine ,Temporomandibular joint ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,medicine.anatomical_structure ,Orthopedic surgery ,medicine ,Deformity ,medicine.symptom ,business ,Pelvis ,Torticollis - Abstract
Introduction. The relevance of the feet planovalgus deformity problem is caused by its prevalence and tendency to progression, insufficient knowledge of a number of aspects, and the complexity of treatment. Another urgent pediatric orthopedics problem is the placement torticollis in infants, and the possible relationship of this problem with feet planovalgus deformity. Among the least studied aspects of these diseases categories it is necessary to highlight the problem of the peculiarities of the osteopathic status in children with feet planovalgus deformity with a history of placement torticollis, and the dynamics of clinical manifestations during their osteopathic correction.The aim of the research was to study the features of the osteopathic status in patients with planovalgus deformity of the feet in combination with a history of placement torticollis and without such a combination, and to evaluate the clinical efficacy of complex therapy, including osteopathic correction.Materials and methods. The study involved 60 patients aged 7–14 years with planovalgus deformity of the feet. The study participants were divided into two groups. The first group included 30 patients with planovalgus deformity of the feet and a history of placement torticollis. The second group included 30 patients with planovalgus deformity of the feet, who did not have a history of torticollis. All study participants received complex therapy (orthopedic treatment and osteopathic correction). At the beginning and at the end of the course of osteopathic correction, the condition of the arch of the foot (the severity of fl at feet) and osteopathic status were assessed in all study participants.Results. In the first group there were prevailed somatic dysfunctions (SD) of the head region, the detection rate was 86%, the pelvic region (somatic component — C), 76 %, and the neck region (C), 13 %. Among the second group participants there were prevailed SD of the pelvic region (C) — the detection rate was 100 %, the lower extremities, 43 %, and the lumbar region (C), 13 %. The SD in the pelvic region was the most typical; however, more often (ppppppConclusion. The revealed differences between the participants of the groups in the prevalence and number of regional dysfunctions and the prevalence of local SD could, presumably, reflect the relationship between the placement torticollis and planovalgus deformity of the feet. Based on the absence of differences in the degree of severity of flat feet between the participants of the groups, it can be assumed that the history of the placement torticollis is not associated by itself with the aggravation of the severity of feet planovalgus deformity.
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- 2021
34. Longitudinal evaluation of patients with isolated head tremor
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Gina Ferrazzano, Antonella Conte, Giovanni Defazio, Alfredo Berardelli, Maria Ilenia De Bartolo, Giovanni Fabbrini, Daniele Belvisi, Matteo Costanzo, and Viola Baione
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Longitudinal study ,medicine.medical_specialty ,Movement disorders ,Head tremor ,Spasmodic Torticollis ,Physical medicine and rehabilitation ,Rating scale ,Tremor ,Humans ,Medicine ,Longitudinal Studies ,Cervical dystonia ,Pathological ,Torticollis ,Dystonia ,business.industry ,Isolated head tremor ,medicine.disease ,nervous system diseases ,Neurology ,Dystonic Disorders ,Neurology (clinical) ,Geriatrics and Gerontology ,medicine.symptom ,business ,Neck - Abstract
Introduction Isolated head tremor, a pathological condition characterized by head tremor without dystonic postures or tremor in other body parts, has recently been suggested to be a form of dystonia. It is however still unclear whether isolated head tremor precedes dystonia or remains unmodified overtime. Methods We enrolled 20 patients with isolated head tremor. For each patient, we assessed videos recorded at enrollment and after 5 years. The videotapes were reviewed by two independent experienced movement disorder specialists who evaluated and scored tremor and CD severity using the Fahn-Tolosa-Marin Clinical Rating Scale for Tremor and the revised Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), respectively. Results Upon enrollment, all 20 patients showed isolated head tremor. Mean tremor severity was 2.7 ± 0.9 as measured using the Fahn-Tolosa-Marin Clinical Rating Scale for Tremor total score. At the 5-year follow-up examination, 15 (75%) of the 20 patients with isolated head tremor showed dystonic postures in the neck, while the remaining 5 patients (25%) had only isolated head tremor. Mean severity of dystonia as measured using the TWSTRS-2 total score was 11.8 ± 3.6. Head tremor severity was unchanged between baseline and the 5-year follow-up examination (p > 0.05). At the follow-up examination, no patients had tremor or dystonia in a body part other than the neck, nor did they develop bradykinesia or other parkinsonian signs. Conclusions Our longitudinal study demonstrated that patients with isolated head tremor may develop cervical dystonia over time.
- Published
- 2022
35. C1-2 rotatory subluxation as a presenting sign in juvenile rheumatoid arthritis
- Author
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Amanda T Whitaker and Michael P. Glotzbecker
- Subjects
musculoskeletal diseases ,Subluxation ,030222 orthopedics ,medicine.medical_specialty ,business.industry ,Occiput ,Basilar invagination ,medicine.disease ,Rash ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Joint pain ,Orthopedic surgery ,medicine ,Orthopedics and Sports Medicine ,medicine.symptom ,skin and connective tissue diseases ,business ,030217 neurology & neurosurgery ,Juvenile rheumatoid arthritis ,Torticollis - Abstract
Case report. Juvenile rheumatoid arthritis (JRA) typically presents with fever, rash, anterior uveitis, and/or joint pain. We present three cases with initial torticollis due to rotatory subluxation of C1–C2 as an initial sign of JRA. Three girls, ages 5–9, presented with C1-2 rotatory subluxation. Traction was able to reduce the atlanto-axial joint in all cases. Based on imaging, history, exam, and laboratory results, they were diagnosed with JRA. After reduction of the atlantoaxial joint, they were transitioned to a halo vest and disease-modifying antirheumatic drugs (DMARDs). The older 2 children underwent C1-2 fusion. The younger child has minimal symptoms and has not undergone surgical intervention 4 years from initial presentation. Rotatory subluxation can be the first presenting sign of JRA. Younger children may be able to be treated conservatively with traction and medication, while older children may require occiput to C2 fusion due to bony destruction and basilar invagination. IV.
- Published
- 2021
36. Microstructural Abnormalities of the Dentatorubrothalamic Tract in Cervical Dystonia
- Author
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Bruce G. Pike, Justyna R. Sarna, Yamile Jasaui, Conrad P. Rockel, Tamara Pringsheim, Abbas F. Sadikot, Rachel E. Sondergaard, Filomeno Cortese, Oury Monchi, and Davide Martino
- Subjects
0301 basic medicine ,medicine.medical_specialty ,03 medical and health sciences ,0302 clinical medicine ,Fractional anisotropy ,medicine ,Humans ,In patient ,Diffusion Tractography ,Cervical dystonia ,Torticollis ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Pathophysiology ,3. Good health ,Diffusion Magnetic Resonance Imaging ,Diffusion Tensor Imaging ,030104 developmental biology ,Neurology ,Anisotropy ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery ,Tractography ,Diffusion MRI - Abstract
Background The dentatorubrothalamic tract (DRTT) remains understudied in idiopathic cervical dystonia (CD), despite evidence that the pathway is relevant in the pathophysiology of the disorder. Objective The aim of this study was to examine the DRTT in patients with CD using diffusion tensor imaging (DTI)-based tractography. Methods Magnetic resonance imaging scans from 67 participants were collected to calculate diffusion tractography metrics using a binary tractography-based DRTT template. Fractional anisotropy and diffusivity measures of left and right DRTT were computed and compared between 32 subjects with CD and 35 age-matched healthy volunteers. Results Fractional anisotropy of right DRTT and mean and axial diffusivity of left DRTT were significantly reduced in patients with CD. Similar abnormalities were observed in patients with focal CD and patients with CD without tremor. DTI metrics did not correlate with disease duration or severity. Conclusions Significant reductions in DTI measures suggest microstructural abnormalities within the DRTT in CD, characterized by a tractography pattern consistent with decreased axonal integrity. © 2021 International Parkinson and Movement Disorder Society.
- Published
- 2021
37. Neuropsychological correlates of prospective memory: A comparison between tremor-dominant Parkinson’s disease and cervical dystonia
- Author
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Alfonsina D'Iorio, Gabriella Santangelo, Marcello Esposito, Marianna Amboni, Gianpaolo Maggi, Carmine Vitale, D'Iorio, A., Esposito, M., Maggi, G., Amboni, M., Vitale, C., and Santangelo, G.
- Subjects
Male ,medicine.medical_specialty ,Primary cervical ,Movement disorders ,Memory, Episodic ,Neuropsychological Tests ,Audiology ,Executive Function ,03 medical and health sciences ,0302 clinical medicine ,Memory ,Retrospective Studie ,Retrospective memory ,Physiology (medical) ,Tremor ,Prospective memory ,medicine ,Humans ,Cognitive Dysfunction ,Cervical dystonia ,Prefrontal cortex ,Torticollis ,Aged ,Retrospective Studies ,Dystonia ,Memory Disorders ,Idiopathic Parkinson's disease ,business.industry ,Parkinson Disease ,General Medicine ,Middle Aged ,Executive functions ,medicine.disease ,Neurology ,030220 oncology & carcinogenesis ,Torticolli ,Female ,Surgery ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Human ,Memory Disorder ,Executive dysfunction - Abstract
Cervical Dystonia (CD) and Parkinson's disease, particularly tremor-dominant motor phenotype (TD-PD), showed a selective deficit of time-based prospective memory (TBPM). The two movement disorders are mainly characterized by dysfunctions of basal-ganglia and prefrontal cortex but it is reported that cerebellum also plays a key role in their pathogenesis. These cerebral structures are specifically involved in TBPM rather than in event-based PM (EBPM), but until now no study directly compared these two components of PM between CD and TD-PD patients. Therefore, the present study aimed at investigating if differences in PM functioning between CD and TD-PD patients might exist and if the type of movement disorder moderated the relationship between deficit of PM and deficit of executive functions and retrospective memory. Thirty TD-PD, 27CD patients and 29 healthy subjects (HCs), matched for demographic features, underwent neuropsychological tests for PM, executive functions, retrospective memory and self-rated questionnaires. The three groups did not differ on neuropsychological variables except for TBPM where TD-PD and CD patients performed worse than HCs; moreover, TD-PD performed worse than CD patients. Moderation analysis indicated that the type of movement disorder moderated the relationship between executive dysfunction and TBPM, but not EBPM. In conclusion, selective deficit of TBPM characterizes both CD and TD-PD but it is associated with executive dysfunction only in TD-PD. It might be possible to speculate that the involvement of the cerebellum, responsible for internal timing processes, could explain the impairment of TBPM in both movement disorders. This issue deserves to be explored in future neuroimaging studies.
- Published
- 2021
38. Unusual presentation of an unusual disease: A very delayed diagnosis of Grisel’s syndrome
- Author
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Cevriye Mülkoğlu, Basak Mansiz-Kaplan, Hakan Genç, and Seçil Vural
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,Rehabilitation ,torticollis ,Respiratory infection ,Physical Therapy, Sports Therapy and Rehabilitation ,Case Report ,Disease ,medicine.disease ,Delayed diagnosis ,Grisel’s syndrome ,non-traumatic atlantoaxial subluxation ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Outpatient clinic ,Neurosurgery ,Presentation (obstetrics) ,030223 otorhinolaryngology ,business ,neck stiffness ,Neck stiffness ,030217 neurology & neurosurgery ,Torticollis - Abstract
Grisel’s syndrome (GS) is a rare syndrome which refers only to non-traumatic atlantoaxial subluxation. This syndrome predominantly occurs in young children following an upper respiratory infection or otolaryngologic procedures. An eight-year-old girl with a delayed diagnosis of GS was admitted to our outpatient clinic with complaints of painful torticollis and neck stiffness. Three-dimensional computed tomography revealed rotatory atlantoaxial subluxation. After consulting with the neurosurgery department, the patient underwent surgery. The significance of this patient was that she was unable to be diagnosed early and atlantoaxial subluxation remained hidden for five years without any complications. In conclusion, this rare case highlights the importance of delayed diagnosis of GS and clinicians should be aware of this syndrome.
- Published
- 2021
39. TRAUMATIC ATLANTOAXIAL ROTATORY DISLOCATION IN THE PEDIATRIC POPULATION
- Author
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Cristian Illanes
- Subjects
medicine.medical_specialty ,Arthrodesis ,medicine.medical_treatment ,Diseases of the musculoskeletal system ,03 medical and health sciences ,0302 clinical medicine ,Dislocation (syntax) ,Female patient ,medicine ,Orthopedics and Sports Medicine ,Surgical treatment ,Torticollis ,Axis, Cervical Vertebra ,Orthopedic surgery ,030222 orthopedics ,Atlantoaxial dislocation ,medicine.disease ,Surgery ,Rotatory ,RC925-935 ,Neurology (clinical) ,Atlas ,030217 neurology & neurosurgery ,RD701-811 ,Case series ,Pediatric population - Abstract
Objective: The treatment of C1-C2 rotatory dislocation remains controversial and surgery is rare. Surgical treatment is indicated when the injury satisfies the instability criteria or when it cannot be reduced. The objective of this study is to analyze the principles and the adaptations necessary for treating these injuries in the pediatric population. Methods: A retrospective case series study. Three cases of patients diagnosed with traumatic C1-C2 rotatory dislocation and treated surgically in our hospital were studied. Through critical analysis of the available literature, a practical guide was proposed to establish the principles and competencies for the treatment of these injuries. Results: The operated cases were female patients between 8 and 16 years of age, with a diagnosis of traumatic atlantoaxial dislocation. Two patients required preoperative skeletal traction with halo. All patients underwent posterior instrumented arthrodesis, two with a transarticular screw technique and one with mass and C2 isthmic (Göel-Harms) screws. Conclusion:. It is essential to determine if the injury is stable and reducible. We recommend treating this type of injury keeping the criteria and competencies related to the stability, alignment, biology and function of the spine in mind. Level of evidence IV; Case series.
- Published
- 2021
40. Motor learning deficits in cervical dystonia point to defective basal ganglia circuitry
- Author
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Alexander Münchau, Amrei Kienzle, Elinor Tzvi, Vera-Maria Herrmann, Anne Weissbach, Tobias Bäumer, Julius Verrel, Johanna Junker, and Sebastian Loens
- Subjects
0301 basic medicine ,Serial reaction time ,Male ,Cerebellum ,Science ,Thalamus ,Article ,Basal Ganglia ,03 medical and health sciences ,0302 clinical medicine ,Basal ganglia ,medicine ,Reaction Time ,Humans ,Learning ,Cervical dystonia ,Torticollis ,Aged ,Dystonia ,Multidisciplinary ,business.industry ,Motor Cortex ,Middle Aged ,medicine.disease ,Adaptation, Physiological ,030104 developmental biology ,medicine.anatomical_structure ,Eyeblink conditioning ,Motor Skills ,Medicine ,Female ,Motor learning ,business ,Neuroscience ,030217 neurology & neurosurgery ,Psychomotor Performance - Abstract
Dystonia is conceptualized as a network disorder involving basal ganglia, thalamus, sensorimotor cortex and the cerebellum. The cerebellum has been implicated in dystonia pathophysiology, but studies testing cerebellar function in dystonia patients have provided equivocal results. This study aimed to further elucidate motor network deficits in cervical dystonia with special interest in the role of the cerebellum. To this end we investigated motor learning tasks, that differ in their dependence on cerebellar and basal ganglia functioning. In 18 cervical dystonia patients and 18 age matched healthy controls we measured implicit motor sequence learning using a 12-item serial reaction time task mostly targeting basal ganglia circuitry and motor adaptation and eyeblink conditioning as markers of cerebellar functioning. ANOVA showed that motor sequence learning was overall impaired in cervical dystonia (p = 0.01). Moreover, unlike healthy controls, patients did not show a learning effect in the first part of the experiment. Visuomotor adaptation and eyeblink conditioning were normal. In conclusion, these data lend support to the notion that motor learning deficits in cervical dystonia relate to basal ganglia-thalamo-cortical loops rather than being a result of defective cerebellar circuitry.
- Published
- 2021
41. Botulinum toxin injection changes resting state cerebellar connectivity in cervical dystonia
- Author
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Petr Kaňovský, Pavel Otruba, Lenka Hvizdošová, Pavel Hok, Petr Hluštík, Markéta Trnečková, Zbyněk Tüdös, Martin Nevrlý, and Michaela Kaiserová
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Cerebellum ,Frontal cortex ,Neurology ,Rest ,Science ,Botulinum toxin injection ,Injections, Intralesional ,Severity of Illness Index ,Article ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Text mining ,medicine ,Humans ,Cervical dystonia ,Botulinum Toxins, Type A ,Torticollis ,Cerebral Cortex ,Dystonia ,Multidisciplinary ,Resting state fMRI ,business.industry ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Treatment Outcome ,030104 developmental biology ,medicine.anatomical_structure ,nervous system ,Anesthesia ,Medicine ,Female ,business ,030217 neurology & neurosurgery ,Neuroscience - Abstract
In cervical dystonia, functional MRI (fMRI) evidence indicates changes in several resting state networks, which revert in part following the botulinum neurotoxin A (BoNT) therapy. Recently, the involvement of the cerebellum in dystonia has gained attention. The aim of our study was to compare connectivity between cerebellar subdivisions and the rest of the brain before and after BoNT treatment. Seventeen patients with cervical dystonia indicated for treatment with BoNT were enrolled (14 female, aged 50.2 ± 8.5 years, range 38–63 years). Clinical and fMRI examinations were carried out before and 4 weeks after BoNT injection. Clinical severity was evaluated using TWSTRS. Functional MRI data were acquired on a 1.5 T scanner during 8 min rest. Seed-based functional connectivity analysis was performed using data extracted from atlas-defined cerebellar areas in both datasets. Clinical scores demonstrated satisfactory BoNT effect. After treatment, connectivity decreased between the vermis lobule VIIIa and the left dorsal mesial frontal cortex. Positive correlations between the connectivity differences and the clinical improvement were detected for the right lobule VI, right crus II, vermis VIIIb and the right lobule IX. Our data provide evidence for modulation of cerebello-cortical connectivity resulting from successful treatment by botulinum neurotoxin.
- Published
- 2021
42. A Case of Torticollis in an 8-Month-Old Infant Caused by Posterior Fossa Arachnoid Cyst: An Important Entity for Differential Diagnosis
- Author
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Kasey J Han, Taemin Oh, John K. Yue, Peter P. Sun, and Diana Chang
- Subjects
medicine.medical_specialty ,Posterior fossa ,lcsh:Medicine ,Case Report ,Pediatrics ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Arachnoid cyst ,Clinical Research ,arachnoid cyst ,differential diagnosis ,Medicine ,Pediatric ,Cerebellopontine angle arachnoid cyst ,screening and diagnosis ,business.industry ,lcsh:R ,Neurosciences ,lcsh:RJ1-570 ,posterior fossa ,torticollis ,lcsh:Pediatrics ,medicine.disease ,Posterior fossa arachnoid cyst ,Detection ,Clinical diagnosis ,Radiology ,Differential diagnosis ,business ,Fenestration ,030217 neurology & neurosurgery ,Torticollis ,4.2 Evaluation of markers and technologies - Abstract
Torticollis is a clinical diagnosis with heterogeneous causes. We present an unusual case of acquired torticollis in an 8-month-old female infant with a large cerebellopontine angle arachnoid cyst. Symptoms resolved after surgical fenestration. Non-traumatic acquired or new-onset torticollis requires brain imaging, and posterior fossa lesions are an important entity in the differential for pediatric clinicians.
- Published
- 2021
43. The comparison of head and neck alignment in children with visual and hearing impairments and its relation with anthropometrical dimensions
- Author
-
Hasan Daneshmandi, Ali Shamsi Majalan, Mostafa Babakhani, and Karanian F
- Subjects
visual impairment ,hearing impairment ,anthropometrical dimensions ,forward head posture ,torticollis ,Medicine - Abstract
Purpose: The aim of this study was to compare head and neck alignment in children with visual and hearing impairments and its relation with anthropometrical parameters. Methods: The study was a descriptive, correlational analysis within which the relations between dependent and independent variables have been studied. Thirty children with poor vision, 30 children with hearing loss and finally 30 healthy ones ranged 6-12 years old were selected randomly. Anteroposterior and mediolateral photographs of the neck were obtained to check forward head and torticollis postures. Anthropometric parameters (head, neck and thorax circumference, neck, shoulder and thorax width, neck length, the distance from tragus to sternal notch and sitting-height) were measured. Statistical analysis of data was performed by 1-way ANOVA and Pearson correlation coefficient. Results: The statistical results indicated that forward head angle was less in the visually impaired group than the group with hearing loss (P = 0.001) and the healthy group (P = 0.017). The lateral flexion angle was more in the group with hearing loss than the healthy group (P = 0.001). There is also a positive significant correlation between head circumference (P = 0.025), neck length (P = 0.001), sternal notch-tragus distance (P = 0.003), and sitting-height (P = 0.014) with forward head posture. No significant relation was observed between other anthropometrical parameters with structural profile variable (Forward head and torticollis). Conclusion: The results of this study indicate that visual and hearing impairments can affect the head and neck alignment of children and this alignment has a significant relation with some of the anthropometrical dimensions. Therefore, it is necessary to pay more attention to treatment exercises in order to correct and improve body posture and changed anthropometrical dimensions in children with visual and hearing impairments.
- Published
- 2014
44. Torticollis in a 7-year-old child: an alarming sign not to be turned away
- Author
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A.F. Salokha and O.Ya. Borys
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,education ,medicine ,business ,medicine.disease ,Sign (mathematics) ,Torticollis - Abstract
Acquired torticollis is not a separate disease rather a warning sign of an underlying disorder. The etiology of torticollis in children is quite wide. Hematogenous osteomyelitis of the first cervical vertebra (the atlas) is an extremely rare and potentially dangerous pathology. The aim is to acquaint physicians of different specialties with an extremely rare condition – acute hematogenous osteomyelitis of the atlas. Case Report. A case of osteomyelitis of the first cervical vertebra in a 7-year-old boy is presented. An important sign of the disease is torticollis. Conclusions. Hematogenous osteomyelitis of the atlas is an extremely rare and potentially dangerous pathology. Regardless of its incidence, it must be considered when examining a child with acquired wryneck. All the ENT specialists must possess the knowledge of this disease, as they are most likely the first doctors to see such a child. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: torticollis, osteomyelitis of the atlas, C1 osteomyelitis, vertebral osteomyelitis, children.
- Published
- 2021
45. Primary treatment of atlantoaxial rotatory fixation in children: a multicenter, retrospective series of 125 cases
- Author
-
Naoto Shiba, Takeharu Sasaki, Tsunemasa Matsubara, Kei Yamada, Masafumi Goto, Kenji Mizokami, Shoji Iwahashi, Hidetomo Nakamura, Kotaro Jimbo, Kimiaki Sato, and Takahiro Shimazaki
- Subjects
medicine.medical_specialty ,Neck pain ,Wilcoxon signed-rank test ,business.industry ,General Medicine ,medicine.disease ,Logistic regression ,Surgery ,03 medical and health sciences ,Fixation (surgical) ,0302 clinical medicine ,Symptom relief ,030220 oncology & carcinogenesis ,medicine ,Primary treatment ,medicine.symptom ,business ,Range of motion ,030217 neurology & neurosurgery ,Torticollis - Abstract
OBJECTIVEThe primary treatment for atlantoaxial rotatory fixation (AARF) remains controversial. The aim of this study was to investigate the primary treatment for AARF and create an algorithm for primary treatment.METHODSThe authors analyzed the data of 125 pediatric patients at four medical institutions from April 1989 to December 2018. The patients were reported to have neck pain, torticollis, and restricted neck range of motion and were diagnosed according to the Fielding classification as type I or II. As a primary treatment, 88 patients received neck collar fixation, and 28 of these patients did not show symptom relief and required Glisson traction. Thirty-seven patients were primarily treated with Glisson traction. In total, 65 patients, including neck collar treatment failure patients, underwent Glisson traction in hospitals.RESULTSThe success rate of treatment was significantly higher in the Glisson traction group (97.3%) than in the neck collar fixation group (68.2%) (p = 0.0001, Wilcoxon test). In the neck collar effective group, Fielding type I was more predominant (p = 0.0002, Wilcoxon test) and the duration from onset to the first visit was shorter (p = 0.02, Wilcoxon test) than that in the neck collar ineffective group. Using multivariate logistic regression analysis with the above items, the authors generalized from the estimated formula: logit [p(success group by neck collar fixation group)|duration from onset to the first visit (x1), Fielding type (x2)] = 0.4(intercept) − 0.15x1 + 1.06x2, where x1 is the number of days and x2 = 1 (for Fielding type I) or −1 (for Fielding type II). In cases for which the score is a positive value, the neck collar should be chosen. Conversely, in cases for which the score is a negative value, Glisson traction should be the first choice.CONCLUSIONSAccording to this formula, in patients with Fielding type I AARF, neck collar fixation should be allowed only if the duration from onset is ≤ 10 days. In patients with Fielding type II, because the score would be a negative value, Glisson traction should be performed as the primary treatment.
- Published
- 2021
46. Ranking of Risk Factors for the Formation of Torticollis in Children
- Author
-
M. Emilbekov
- Subjects
medicine ,General Medicine ,Psychology ,medicine.disease ,Ranking (information retrieval) ,Clinical psychology ,Torticollis - Abstract
The article presents the ranked risk factors for the development of torticollis in children. We conducted a study of 72 children with a diagnosis of torticollis at the age of 3 months to 17 years of age, who were treated at the National Center for Maternal and Child Health (Kyrgyz Republic). Significant risk factors for the birth of children with torticollis were toxicosis and transverse presentation of the fetus, followed by the threat of miscarriage and childbirth with stimulation.
- Published
- 2021
47. Abnormal regional homogeneity and its relationship with symptom severity in cervical dystonia: a rest state fMRI study
- Author
-
Jing Wei, Yiwu Lei, Chao Qin, Lu Yang, Yuhong Qin, Xiuqiong Chen, Chunhui Lu, Wenyan Jiang, Yang Liu, Caiyou Hu, Huihui Li, Shuguang Luo, and Shubao Wei
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cerebellum ,Neurology ,Audiology ,Resting-state functional magnetic resonance ,Regional homogeneity ,behavioral disciplines and activities ,lcsh:RC346-429 ,Rest state ,03 medical and health sciences ,0302 clinical medicine ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Neurochemistry ,Cervical dystonia ,Prefrontal cortex ,Torticollis ,Default mode network ,lcsh:Neurology. Diseases of the nervous system ,Brain Mapping ,business.industry ,Brain ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,030227 psychiatry ,medicine.anatomical_structure ,nervous system ,Female ,Neurology (clinical) ,Neurosurgery ,business ,030217 neurology & neurosurgery ,psychological phenomena and processes ,Research Article - Abstract
Background Although several brain networks play important roles in cervical dystonia (CD) patients, regional homogeneity (ReHo) changes in CD patients have not been clarified. We investigated to explore ReHo in CD patients at rest and analyzed its correlations with symptom severity as measured by Tsui scale. Methods A total of 19 CD patients and 21 gender-, age-, and education-matched healthy controls underwent fMRI scans at rest state. Data were analyzed by ReHo method. Results Patients showed increased ReHo in the right cerebellum crus I and decreased ReHo in the right superior medial prefrontal cortex (MPFC). Moreover, the right precentral gyrus, right insula, and bilateral middle cingulate gyrus also showed increased ReHo values. A significantly positive correlation was observed between ReHo value in the right cerebellum crus I and symptom severity (p Conclusions Our investigation suggested abnormal ReHo existed in brain regions of the “pain matrix” and salience network (the right insula and bilateral middle cingulate gyrus), the motor network (the right precentral gyrus), the cerebellum and MPFC and further highlighted the significance of these networks in the pathology of CD.
- Published
- 2021
48. Bilateral sternocleidomastoid pseudotumors—a case report and literature review
- Author
-
Ruhaid Khurram, Luke Durnford, Rahul Khamar, and Muhammed Sufyaan Ebrahim Patel
- Subjects
lcsh:Medical physics. Medical radiology. Nuclear medicine ,medicine.medical_specialty ,Ultrasound scan ,lcsh:R895-920 ,Case Report ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Fibromatosis colli ,Torticollis ,Anterior neck ,Pediatric ,business.industry ,fungi ,Soft tissue ,Congenital torticollis ,Emergency department ,Bilateral ,medicine.disease ,stomatognathic diseases ,Sternocleidomastoid ,Pseudotumors ,Radiology ,Differential diagnosis ,business ,030217 neurology & neurosurgery - Abstract
Sternocleidomastoid (SCM) pseudotumors, also known as fibromatosis colli or congenital torticollis, are painless benign neck lumps found in newborns. Whilst unilateral cases are relatively common, bilateral SCM pseudotumors are a rare phenomenon with only a handful of cases reported internationally. We present the case of a 5-week-old infant who was brought to the emergency department with painless, bilateral, palpable anterior neck masses following a slightly traumatic but otherwise uncomplicated spontaneous delivery. An ultrasound scan of his neck revealed well-defined soft tissue lesions within both of the SCM muscles. He was subsequently diagnosed with bilateral SCM pseudotumors. This case emphasizes the importance of considering this entity as a differential diagnosis in infants presenting with bilateral palpable neck masses.
- Published
- 2021
49. Binocular integration and stereopsis in children with television torticollis
- Author
-
Hang Chu, Wenjuan Xie, Wanshu Huang, Mark D. Wiederhold, Guanrong Zhang, Dongmei Wang, Cheng Yang, Li Yan, Brenda K. Wiederhold, Ying Cui, and Jin Zeng
- Subjects
Male ,Refractive error ,medicine.medical_specialty ,genetic structures ,media_common.quotation_subject ,Balance test ,Audiology ,Virtual reality ,Binocular integration ,lcsh:Ophthalmology ,medicine ,Contrast (vision) ,Humans ,Stereopsis ,Child ,Torticollis ,media_common ,Retrospective Studies ,Depth Perception ,Vision, Binocular ,business.industry ,Significant difference ,General Medicine ,medicine.disease ,Television torticollis ,Stereoscopic acuity ,Ophthalmology ,lcsh:RE1-994 ,Child, Preschool ,Horizontal bar ,Female ,Television ,business ,Research Article - Abstract
Background To observe the characteristics of binocular integration and stereopsis in children with television torticollis. Methods A retrospective study was carried out, where data were collected from 25 children with television torticollis as the disease group after refractive error correction and 25 normal children as the control group. A virtual reality system was used to assess and analyze the characteristics of binocular integration by a contrast balance test and binocular stereopsis. Results The 25 children in the disease group included 17 males and 8 females with an average age of 7.5 ± 1.9 years old and an average binocular spherical equivalent of − 0.35 ± 1.46D. The 25 children in the control group were also 17 males and 8 females with an average age of 7.3 ± 2.2 years old and the average binocular spherical equivalent of − 0.48 ± 0.93D. No significant differences were found in the horizontal bar contrast balance test between the 2 groups at near and far distances. Near-distance vertical bar contrast balance test was normal in 23 subjects and suppressed in 2 subjects in the control group, while it was normal in 13 subjects and suppressed in 12 subjects in the disease group, which showed a statistically significant difference (P = 0.002). Far distance vertical bar contrast balance test was normal in 24 subjects and suppressed in 1 subject in the control group, normal in 7 subjects and suppressed in 18 subjects in the disease group, showing a statistically significant difference (P = 0.000). All subjects in the 2 groups showed 100〞 as near distance stereoacuity. At far distance, the mean stereoacuity was 176.00〞 ± 92.56〞 in the control group, and 352.00〞 ± 270.99〞 in the disease group, with a statistically significant difference (P = 0.011). Conclusion By using virtual reality technology, defects in binocular visual function were found in children whose television torticollis persisted after regular refractive error correction. Television torticollis may be associated with the deficit of binocular integration for vertical bars and far distance stereopsis.
- Published
- 2021
50. We Must Talk about Sex and Focal Dystonia
- Author
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Sean O'Riordan, Michael Hutchinson, Shameer Rafee, and Richard B. Reilly
- Subjects
Adult ,0301 basic medicine ,No reference ,Disease pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Basal ganglia ,otorhinolaryngologic diseases ,medicine ,Humans ,In patient ,Cervical dystonia ,Torticollis ,Dystonia ,Movement Disorders ,business.industry ,Focal dystonia ,medicine.disease ,nervous system diseases ,Sexual dimorphism ,030104 developmental biology ,Neurology ,Dystonic Disorders ,Neurology (clinical) ,business ,Neuroscience ,030217 neurology & neurosurgery - Abstract
In a recent workshop on "Defining research priorities in dystonia,", there was absolutely no reference to sex as a factor in disease pathogenesis. In this viewpoint paper, we argue that the most distinctive aspects of adult onset isolated focal dystonia are the marked sex-related differences demonstrated by epidemiological, clinical, and laboratory studies in patients with adult onset dystonia, particularly in cervical dystonia, the most common presentation. We propose that the future focus of research should be on neurobiological mechanisms underlying the profound sexual dimorphism in this disorder. Targeting research into gamma aminobutyric acid (GABA)ergic function, which also shows similar sexual dimorphism, would be most productive in elucidating the pathogenesis of adult onset dystonia. © 2021 International Parkinson and Movement Disorder Society.
- Published
- 2021
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