Twist the head to the side

Introduction The twisting movement of the head to one side is the involuntary contraction of the cervical muscles, causing the head to twist to one side or to tilt. It is one of the characteristics of the sparse torticollis.

Cause

1. Genetic factors: Partial adult dystonia localized seizures are genetically determined. Great progress has been made in the genetic studies of systemic dystonia, and there has been some progress in the genetic studies that affect the lower limit of dystonia. In some families, cervical dystonia is seen in about 10% of first- and second-degree relatives, with evidence of autosomal dominant inheritance with reduced penetrance. A study of a family of three patients with spastic torticollis found that the onset of a family was associated with chromosome 18P. The latter two families lack the involvement of the DYT1 locus. This indicates that there are genetic abnormalities in the pathogenesis of cervical muscle dystonia.

2. Trauma: Trauma has been considered to be the cause of spastic torticollis. It is reported in the literature that 9%-16% of patients have a history of head or neck trauma, usually occurring weeks to months before onset.

3. Abnormal vestibular function: There is a report of increased vestibular-ocular reflex reactivity or asymmetry in patients with spastic torticollis, which cannot be corrected after treatment with botulinum toxin. Vestibular abnormalities are not primary abnormalities, and other types of localized dystonia (eg, writing sputum, sputum) can also be associated with spastic torticollis. Deafness, dizziness, and ataxia are not characteristic of a spasmodic torticollis. At the same time, many patients have no vestibular reflex abnormalities, but have a longer temporal sparse neck, which may be secondary to vestibular abnormalities. Spastic torticollis causes long-term head posture abnormalities.

4. Others: Short-term or long-term neck vibration stimulation found that there is a significant difference in the head position of the patient. This is due to the change of the sensory stimulation of the surrounding body, which causes the central control of the head and neck to compensate for the reversal of the mediating function, afferent nerve The impulsive central integration function has obstacles.

diagnosis:

The diagnosis of this disease is relatively easy, and it is difficult to determine the muscles involved. According to its specific clinical manifestations, the cervical tendon or clonic squats the head to one side, and the neurological examination (including the cone system, extrapyramidal and cerebellar function, sensation, etc.) is within the normal range. Due to long-term muscle spasms, affected muscles are often abnormally solid and hypertrophied. There were no abnormal findings in head CT and EEG. According to the symptoms, a diagnosis of spastic torticollis can be made. Combined with palpation and the above electromyography, local block and neck muscle performance, after comprehensive analysis of the patient, a list of clinical diagnosis and affected muscles is made, and a treatment plan is formulated.

an examination

Related inspection

Electroencephalogram examination electromyogram

The diagnosis of this disease is relatively easy, and it is difficult to determine the muscles involved. According to its specific clinical manifestations, the cervical tendon or clonic squats the head to one side, and the neurological examination (including the cone system, extrapyramidal and cerebellar function, sensation, etc.) is within the normal range. Due to long-term muscle spasms, affected muscles are often abnormally solid and hypertrophied. There were no abnormal findings in head CT and EEG. According to the symptoms, a diagnosis of spastic torticollis can be made. Combined with palpation and the above electromyography, local block and neck muscle performance, after comprehensive analysis of the patient, a list of clinical diagnosis and affected muscles is made, and a treatment plan is formulated.

Differential diagnosis

Torsion spasm: torsion spasm, also known as idiopathic torsion spasm (ITS), torsion dystonia, primary dystonia, clinical dystonia And the limbs, trunk and even the whole body are characterized by intense and involuntary torsion. It is divided into primary and secondary, and primary is more common.

Torsional action: a group of symptoms consisting of repetitive involuntary movements caused by incompatibility of the skeletal muscles of the body and antagonistic muscles, intermittent intermittent contraction, and abnormal torsional postures. 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.

The diagnosis of this disease is relatively easy, and it is difficult to determine the muscles involved. According to its specific clinical manifestations, the cervical tendon or clonic squats the head to one side, and the neurological examination (including the cone system, extrapyramidal and cerebellar function, sensation, etc.) is within the normal range. Due to long-term muscle spasms, affected muscles are often abnormally solid and hypertrophied. There were no abnormal findings in head CT and EEG. According to the symptoms, a diagnosis of spastic torticollis can be made. Combined with palpation and the above electromyography, local block and neck muscle performance, after comprehensive analysis of the patient, a list of clinical diagnosis and affected muscles is made, and a treatment plan is formulated.

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