Spasmodic torticollis is one of the most common diseases in adults associated with the onset of dystonia. The only symptom is chaotic muscle contraction. It appears due to problems in the brain stem. This disease is diagnosed after 30 years. If you start treatment immediately, you can achieve a full recovery, but most often the pathology progresses and becomes chronic. Only 10% of patients have remission. It is almost impossible to achieve maximum elimination of the problem using only medical methods.
If we talk about external symptoms, it should be noted violent turns of the head to the side. Sometimes she can lean back or lean. Some patients try to take a more comfortable posture, which allows them to alleviate symptoms. In a dream, spastic torticollis can go into a state of rest. However, it intensifies during feelings of anxiety and tension. If a person has been ill with this disease for a long time, then he may develop osteochondrosis, which affects the cervical region of the spine, as well as radiculopathy. It is manifested by pain in the hands.
Causes of occurrence
This disease provokes incorrect impulses. They cause the neck muscles to contract excessively and cause an atypical position of the head. Doctors believe that spastic torticollis in infants and adults occurs due to dysfunction of the extrapyramidal system. To make it clear: violations occur in that part of the brain that ensures the completion of automatic movements. If in this system there are problems with balance, then some functions of body parts may cause malfunctions. Including a disease such as spastic torticollis may appear. As a result, the neck area and muscle activity in it are affected. Erroneous impulses appear that are delivered to the muscles. After that, the latter are in tension, and also often contract. That is why the head does not turn in the right direction.
Such a pathology can occur with severe stress, problems with the brain, while taking certain medications, injuries to the skull and neck, infections. It is also inherited. There is a peripheral form of this disease that occurs after complication of osteochondrosis.
Description of the disease
Spastic torticollis in adults is considered a fairly popular disease: 10 cases of pathology occur per 100 thousand people. Women suffer from this problem twice as often. In 80% of cases, the first symptoms of the disease appear between 19 and 40 years. Therefore, it should be noted that the described disease is a problem that affects people of working age.
Symptoms may be acute or not. This is described in more detail in the ICD. Spastic torticollis has a code of G24.3. Most often, it grows gradually, depending on the stage of development of the disease. Sometimes the primary symptoms are pain in the cervical spine. They provoke their incorrect position of the neck and sudden movements. Some back muscles may also suffer. Turns of the head lead to a sharp increase in muscle tone.
Conditional split
The disease is divided into several types, depending on the side in which the head bends.
- back - retrocollis;
- forward - antecollis;
- on one side - torticollis;
- to the side to the shoulder - laterocollis.
Mixed cases may occur.
Symptomatology
At the initial stage, the patient is able to turn his head, as well as independently correct the situation if the muscles begin to contract sharply. Patients use special gestures called corrective. They allow you to slightly correct the position of the neck.
With the progression of the disease, the participation of the hands is required to turn the head. However, if you remove them, then the skull itself is not held. With the stage running, it is impossible to turn your head.
In addition to the incorrect posture described above, one of the symptoms should also be noted chaotic head movements. They are involuntary, arise due to sharp contractions of the muscles. Thanks to them, diagnosis is facilitated. Such movements may look like nods or “no-no” turns.
Due to the fact that the muscles are constantly in a state of tension, they begin to thicken. Therefore, pathological pains arise. It should be noted that with palpation, tension and hypertrophy are easy to notice.
In the initial degree of the disease, only 1-2 muscles first suffer. However, as it develops, more and more muscles are involved.
Rarely does a situation arise when muscles are strained on both sides at once. In this case, the head remains in the correct position and a small paradox occurs. A spastic torticollis arises without the torticollis itself. The patient is not able to move his head.
Nature of manifestations
If we talk about the nature of the manifestation of symptoms, then, as a rule, in the morning they are minimal. Strengthened by walking, stress and excitement. In the supine position and in a dream, they decrease. Sometimes the described disease can be combined with tremor.
It should be noted that if treatment is not started in time, then over time a person will begin to have problems with the cervical spine. Various prolapses, hernias, radiculopathies, and so on may occur.
Diagnostics
In order to start treatment of spastic torticollis in adults in time, you should immediately contact a neurologist. He will prescribe diagnostic measures that confirm or refute the alleged conclusion. They can be sent for x-ray, to analyze blood vessels, arteries, check the tone of veins, lability of the bloodstream. Electromyographic studies are performed, and potentials that arise in the brain are also viewed.
Pathology treatment
It should be noted that the treatment of spastic torticollis in adults is a rather difficult process. Most drugs have a minimal or short effect. The patient can be helped through the use of conservative methods. As soon as they are exhausted, an operation is immediately scheduled. We consider in more detail below each of the methods.
Conservative methods
Treatment of spasmodic torticollis can be carried out using conservative methods of therapy. Of the medications prescribed, those that have the effect of muscle relaxation. They are combined with antidepressants and anticholinergics. The most effective will be the use of funds made on the basis of botulinum toxin. It is administered intramuscularly in the affected area. This tool temporarily blocks impulses entering the neck. If botulinum toxin was administered correctly, then its effect is enough for six months. After this, the drug must be re-administered.
The second stage of treatment is the use of acupuncture, as well as manual therapy. The latter is carried out carefully. It is necessary to pay attention to relaxation techniques. Perform manual procedures only if the clinical effects have reached maximum results.
The third stage of treatment is the elimination of various motor disorders that were formed due to the action of torticollis. Gymnastics is prescribed, as well as auto-relaxation.
Such treatment is effective in 60% of cases. The duration of the attacks decreases, the muscles cease often and contract uncontrollably, the pain disappears.
In the event that conservative treatment has exhausted itself or initially has not brought any effect, surgical methods are prescribed.
Surgical method
Early surgical treatment of such a disease was to cut the muscle that was affected. Sometimes tendons were eliminated. If the problem was specifically in the nerve, then it was eliminated. However, this method brought a large number of complications, as it caused paralysis, blood supply diseases. Therefore, at the moment, such surgical methods are not used.
In modern medicine, it is customary to use various operations that are performed on the brain. A small hole is made in the skull and electrodes are applied to the affected system. It should be noted that such an intervention requires detailed preparation so as not to damage the vital structures located in the brain.
When this method was first discovered by means of the action of impulses, those areas that were affected were destroyed. However, over time, it was decided that implantation of the electrodes would be safer and more effective. They are tuned to stimulate tension from 130 to 150 Hz and inhibit the formation of impulses, which are aimed at reducing neck muscles. That is why a person has no reason for the occurrence of spastic torticollis.
Treatment in this way brings quite good results. At the moment, there are a large number of successful operations.
Effects
Torticollis brings not only complications in the form of a visual defect. Too long improper head position can lead to the development of various pathologies.
Possible complications include otitis media, sinusitis, problems with the trachea, migraine, impaired speech apparatus, facial asymmetry, osteochondrosis, scoliosis and heart disease.
In order to avoid consequences, an early diagnosis should be made and appropriate treatment methods selected. The sooner the patient begins treatment, the easier it will be to eliminate complications.
Summary
As a result, it should be noted that the described disease is a problem associated with disorders in the nervous system. Symptoms are rather unpleasant and difficult to tolerate due to cosmetic and social defects. Also, a person has problems with self-care.
If this disease is not treated, then over time it will progress. Because of this, more and more muscles will begin to be involved in the process. Accordingly, the already difficult situation will become even narrower.
To cure the patient, conservative and surgical methods are used. The latter are prescribed only if drug therapy could not overcome the problem. In almost 100% of cases, surgery on the neck muscles leads to success. If we are talking about external problems that led to spastic torticollis, Botox can always help to solve them. Therefore, when the first symptoms occur, you should immediately consult a doctor, since the prognosis will be as favorable as possible.