Wednesday, June 1, 2011

Torticollis - stiff neck - Torticollis Treatment

There are several treatments for spasmodic torticollis, the most used is the injection of botulinum toxin in dystonic muscles of the neck. Other treatments include sensory trick, oral medications and deep brain stimulation. They used combinations of these treatments to improve and control the spasms. Selective denervation surgery can provide symptomatic relief, and avoidance of infringement of spinal pain. Spinal fibrosis can occur rapidly.
Physical Therapy:Patients may respond well to local massage, biofeedback, cervical collars.
Sensory trick:A special feature of spasmodic torticollis is to use a sensory trick to temporarily relieve dystonic contractions. Patients achieving their chin with her hands twisting direction contralateral neck, leading to abnormal head deviation correction.
Oral medications:In the past, dopamine blocking agents were used in the treatment of spasmodic torticollis. Treatment is based on the theory that there is an imbalance of basal ganglia dopamine neurotronsmitatorilor. These drugs are no longer used because of severe adverse effects. They cause sedation, parkinsonism, tardive dyskinesia. Other oral drugs may be used to treat early stages of spasmodic torticollis. Use clonazepam, baclofen or benzodiazepines.
Botulinum toxin:The most commonly used treatment for spasmodic torticollis is injected into muscle dystonia botulinum toxin. Toxin type A is frequently used, prevent the release of acetylcholine from the presynaptic axon of the motor plate, dystonic muscle paralysis. By inhibiting the movement of muscle anatagonist, agonist muscles can move freely. Botulinum toxin injections for 12-16 weeks patients have improved. some patients are imunorezistenti the type A substance and require treatment with type B. About 4-17% of patients develop antibodies to botulinum toxin type A treatment with botulinum toxin type A and type B is comparable to a dry mouth but is more common adverse effect .Common side effects include injection site pain, dysphagia by expanding effect on the adjacent muscles, dry mouth, fatigue and muscle weakness adjacent.
Deep brain stimulation:It is a technique recently used as a successful treatment for patients with Parkinson's tremor. This technique is now implanted in patients with spasmodic torticollis in clinical studies. It stimulates the globus pallidus, subthalamic nucleus. The device is similar to a peacemaker, an external battery is placed subcutaneously under the skin or enter the skull. Microelectrodes are placed in the globus pallidus. Adverse effects for those suffering brain stimulation include headache, infection, cognitive dysfunction, seizures, intracerebral hemorrhage, subdural hematoma and intraventricular sea.

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