The "twisted neck disease" should not be underestimated! Changsha Yuxiang Hospital introduces you to spasmodic torticollis

Spasmodic torticollis, commonly known as "crooked neck" by the public, is a common focal dystonia in clinical practice. It is characterized by involuntary contraction of the neck muscles leading to abnormal movements and postures of the head and neck. It manifests as contracture of the neck muscles on one side or cervical vertebrae malformation, which induces the patient's head to tilt to one side, and there are also varying degrees of impaired neck movements.

Not only does it cause muscle and bone pain in patients, affecting their ability to work and live in daily life, but it also makes patients feel anxious because it cannot be cured for a long time and destroys their normal appearance.

Changsha Yuxiang Hospital introduces: According to the different muscles affected by spasmodic torticollis, it can be divided into four types: lateral tilt, rotation, flexion, and backward movement.

1. Clinical manifestations:

1. Head tilt or twist: The patient's head will tilt, turn, or rotate, usually to one side.

2. Neck pain and stiffness: Patients may experience pain and tightness in the neck muscles.

3. Head shaking or neck tremor: The patient may experience involuntary head shaking (nodding or shaking the head) or neck tremor.

4. Abnormal posture: Abnormal position of the head when the patient is standing or sitting may lead to abnormal posture.

5. Most of the symptoms have a slow onset and gradually worsen. They are aggravated by activity, tension, and anger, and are alleviated or disappear during rest and sleep . There is a sensory track (gentle touch or supporting the head and neck with hands can relieve the symptoms).

Most patients have complex and diverse abnormal movement patterns of the head and neck, and conventional MRI (magnetic resonance imaging) does not show serious structural abnormalities, which can easily lead to misdiagnosis and mistreatment.

The pathogenesis of this disease is still unclear, and it is currently considered to be a "neural network dysfunction disease." Epidemiological surveys show that there are many people with spasmodic torticollis, which is more common in people aged 30-40 years old, and the incidence rate in women is usually 1.5-1.9 times that of men. The vast majority of cases are idiopathic, and about 12% of cases show a family history of genetics.

Although there is no cure for spasmodic torticollis, the goal of treatment is to relieve symptoms, improve quality of life, and prevent complications. Several treatments are usually used to relieve symptoms.

2. Treatment methods:

The first is to intervene with medication , but there is no specific drug at present, which can only relieve some symptoms, and long-term medication will cause serious side effects;

The second method is to locally inject botulinum toxin into the affected muscles to reduce muscle tension and relieve spasms , but the effect can only last for 3-6 months, after which repeated injections are required. In the later stage, botulinum toxin becomes ineffective due to drug resistance.

The third is to perform surgical operations such as peripheral nerve section and muscle section, and selective partial subdural spinal nerve root section .

4. Compared with the above-mentioned therapies, DBS technology has replaced nerve destruction and selective peripheral nerve disconnection and has become an important means of surgical treatment of spasmodic torticollis , with the technical advantages of reversibility, adjustability and minimal invasiveness.

3. How to prevent spasmodic torticollis?

Because the cause of spasmodic torticollis is unknown and a small number of patients have a family history, there is currently no active and effective preventive measure. If conditions permit, you should go to the hospital for a regular physical examination every year, because vestibular dysfunction can also induce the formation of torticollis.

At the same time, you should choose a gentle exercise method that suits you, such as walking, cycling, Tai Chi, etc. Especially when going out for exercise in severe winter, you should wear warm clothes and hats, be careful not to be blown by the wind and snow, and do not wash your face and hands with cold water at home to prevent unnecessary stimulation from the cold.

People with spasmodic torticollis must keep a calm mind, develop the habit of taking a nap and going to bed early and getting up early, so as not to overexcite the brain nerves. At the same time, they should cultivate a wide range of interests and hobbies, learn to distract their attention, and communicate more with relatives and friends to slow down the momentum of spasmodic torticollis caused by psychological diseases.

Source: Department of Neurosurgery, Changsha Yuxiang Hospital

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(Edited by Wx)