Twisting action

Introduction Symptoms of repetitive involuntary movements and abnormal torsional postures caused by inconsistencies in the skeletal muscles of the body and antagonistic muscles, intermittent intermittent contractions. Therefore, it is also called dystonicsyndrome. The tension change of this disease is not noticed, but the abnormal posture posture and involuntary transformation action are noticeable. It has torsional properties, including chest and waist and/or upper limb torsion, over-extension or over-curvature of the neck and/or torso. This abnormal posture posture often changes involuntarily and slowly. It can be fixed in one position for a while, then it becomes another abnormal posture, and it repeats intermittently. All disappeared after sleep. Twisting and spasmodic torticollis are just two clinical types of dystonia.

Cause

Can be divided into two categories of primary and symptomatic. Primary muscle tension abnormalities have genetic factors. Metabolic disorders, degeneration, inflammation, tumors, etc. can cause symptomatic muscle tone abnormalities. There are only a few neuropathological studies in this disease, and there is no firm conclusion.

an examination

Related inspection

Joint examination CT examination

There is a paralysis of the neck muscles, especially the synergistic muscles (a group of muscles that cause a "slanted neck" together). Through the patient's repeated torticollis action, the range of affected muscles and the type of the torticollis can be initially determined. In the auxiliary examination, the electromyogram shows the muscles of the primary and secondary tendons, and the CT of the neck can show the affected muscles and hypertrophy, and the brain CT of some patients is abnormal. In most patients, the organs were functioning normally, and no pathological changes associated with the torticollis were found.

Differential diagnosis

1, upper cervical disease: such as rib pain, injury, cervical disc herniation. The patient often complains of neck discomfort, one side of the neck muscles atrophy, the head can be tilted, but there will be no seizures. At the same time, the above lesions may have sensory movements and reflex changes in the upper limbs. The spastic torticollis has no effect on the function of the upper limbs.

2, the skull and neck junction lesions: such as severe craniocerebral junction deformity. These patients often have symptoms of craniocerebral junctional nerve compression, such as unstable walking, difficulty swallowing, muscle weakness in the extremities, increased reflex and muscle tone. It is also characterized by thickening of the neck and low post-hairline. If accompanied by syringomyelia, there may also be upper limb muscle atrophy, segmental pain and tactile separation. Similarly, the patient may have a torticollis, but there will be no seizures.

3, congenital side of the sternocleidomastoid muscle atrophy: common in children, more common in birth injury. The muscle side of the lesion is atrophied. The normal side muscles have compensatory hypertrophy, but there is no seizure.

4. Children's posterior cranial muscle pain: The patient's forced head position in order to relieve pain, resulting in some muscle stiffness in the neck, although there is a head tilt posture, there will be no seizures. At the same time, the patient has obvious symptoms of the posterior cranial, such as headache, vomiting, unstable walking, nystagmus, and a short history. Children should also be differentiated from the torticollis. Because of the lesions on one side of the eye, most of them are paralyzed by some of the eyeballs, causing the head to be in a tilted position when the child is looking at the object.

5, in the end should also be differentiated from the sickle torticollis. The patient has a clear mental factor, sudden onset, frequent changes in symptoms, irregularities, and symptoms quickly disappear after emotional stability.

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