Spastic torticollis is one of the most popular diseases in adults associated with the occurrence 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 complete recovery, but most often the pathology progresses and becomes chronic. Only 10% of patients go into 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 bend over. Some patients try to take a more comfortable position, which allows them to relieve symptoms. During sleep, spasmodic torticollis may go into a state of rest. However, it intensifies during times of anxiety and tension. If a person is 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. She ismanifested by pain in the hands.
Causes of occurrence
This disease is provoked by wrong impulses. They cause the neck muscles to contract excessively and cause an atypical head position. Doctors believe that spastic torticollis in infants and adults occurs due to dysfunction of the extrapyramidal system. To make it clear: there are violations in that part of the brain that provides automatic movements. If there are problems with balance in this system, then malfunctions may occur with some functions of parts of the body. Including a disease such as spastic torticollis may appear. As a result, the neck area and the activity of the muscles in it are affected. There are erroneous impulses that are delivered to the muscles. After that, the latter are in tension, and also often contract. That is why the head is turned in the wrong direction.
Such a pathology can occur with severe stress, problems with the brain, when taking certain medications, injuries of the skull and neck, infections. It is also inherited. There is a peripheral form of this disease, which occurs after a complication of osteochondrosis.
Description of the disease
Spastic torticollis in adults is considered a fairly popular disease: there are 10 cases of pathology per 100 thousand people. Women suffer from this problem twice as often. In 80% of cases, the first symptoms of the disease appear between the ages of 19 and 40. Therefore, it should be noted thatthe ailment described is a problem that affects people of working age.
Symptomatics may or may not be acute. This is described in more detail in the ICD. Spasmodic torticollis has the code G24.3. Most often, it increases gradually, depending on the stage of development of the disease. Sometimes the primary symptoms are pain in the cervical spine. Provoke their incorrect position of the neck and sudden movements. Some back muscles may also suffer. Turning the head leads to the fact that the tone in the muscles increases sharply.
Conditional separation
The disease is divided into several types depending on the side in which the head leans.
- back - retrocollis;
- forward - antecollis;
- to one side - torticollis;
- side to shoulder - laterocollis.
Mixed cases may occur.
Symptomatics
At the initial stage, the patient is able to turn his head, as well as independently correct the position if the muscles begin to contract sharply. Patients use special gestures, which are called corrective. They allow you to slightly correct the position of the neck.
As the disease progresses, hands are required to turn the head. However, if they are removed, then the skull is not held on its own. When the stage is running, it is impossible to turn your head.
In addition to the above incorrect posture, one of the symptoms should also be noted chaotic head movements. They are involuntary, arise due to sharpmuscle contractions. They make diagnosis easier. Such movements may look like head 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 pain occurs. It should be noted that tension and hypertrophy are easy to notice on palpation.
In the initial degree of the disease, only 1-2 muscles first suffer. However, as development progresses, more muscles are involved.
Rarely does a situation arise when muscles are tense on both sides at once. In this case, the head remains in the correct position and a small paradox occurs. There is spastic torticollis without the torticollis itself. The patient is unable to move his head.
The nature of manifestations
If we talk about the nature of the manifestation of symptoms, then, as a rule, in the morning they are minimal. Aggravated by walking, stress and excitement. In the supine position and during sleep, they decrease. Sometimes the described disease can be combined with a 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, radiculopathy, and so on can occur.
Diagnosis
In order to start the treatment of spastic torticollis in adults in time, you must immediately contact a neurologist. He will prescribe diagnostic measures that will confirm or refute the presumptive conclusion. They can send for x-rays, analyze blood vessels,arteries, check the tone of the veins, the lability of the blood tract. Electromyographic studies are being carried out, and potentials that arise in the brain are being viewed.
Treatment of pathology
It should be noted that the treatment of spastic torticollis in adults is a rather difficult process. Most of the drugs have a minimal or short (in time of action) effect. You can help the patient through the use of conservative methods. As soon as they are exhausted, an operation is immediately prescribed. Let's take a closer look at each of the methods below.
Conservative methods
Spastic torticollis can be treated with conservative therapies. Of the medications, those are prescribed that have the effect of relaxing muscles. 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 to the affected area. This tool temporarily blocks the impulses entering the neck. If the botulinum toxin was administered correctly, then its effect will last for six months. After that, the drug must be administered again.
The second stage of treatment is the use of acupuncture as well as manual therapy. The latter is carried out carefully. It is also necessary to pay attention to relaxation techniques. Perform manual techniques only if the clinical effects have reached the maximum result.
The third stage of treatment is to eliminate various motordisorders that were formed as a result of exposure to torticollis. Gymnastics is prescribed, as well as auto-relaxation.
Such treatment is effective in 60% of cases. The duration of attacks decreases, the muscles cease to contract frequently and uncontrollably, the pain disappears.
In the event that conservative treatment has exhausted itself or initially did not bring any effect, surgical methods are prescribed.
Surgical method
Early surgical treatment of this disease was to cut the muscle that was affected. Sometimes the tendons were eliminated. If the problem was specifically in the nerve, then it was also 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 brought to the affected system. It should be noted that such an intervention requires detailed preparation so as not to damage the vital structures in the brain.
When this method was only discovered with the help of impulses, those areas that were affected were destroyed. However, over time, it was decided that the implantation of electrodes would be safer and more effective. They are tuned to stimulate voltage from 130 to 150 Hz and inhibit the formation of impulses that are aimed at contracting the muscles of the neck. Exactlytherefore, the person's reasons for the occurrence of spasmodic torticollis disappear.
Treatment like this brings pretty good results. At the moment, there are a large number of successful operations.
Consequences
Torticollis brings not only complications in the form of a visual defect. Too long an incorrect position of the head can lead to the development of various pathologies.
Possible complications include otitis media, sinusitis, tracheal problems, migraine, speech disorders, facial asymmetry, osteochondrosis, scoliosis and heart disease.
In order to avoid consequences, early diagnosis and the selection of adequate treatment methods should be carried out. The sooner the patient begins treatment, the easier it will be to eliminate complications.
Results
As a conclusion, it should be noted that the described disease is a problem associated with disorders in the nervous system. The symptoms are quite unpleasant and difficult to tolerate due to cosmetic and social defects. Also, a person has problems with self-service.
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.
Conservative and surgical methods are used to cure the patient. The latter are prescribed only if drug therapy has failedovercome the problem. In almost 100% of cases, the operation performed on the neck muscles leads to success. When it comes to external problems caused by spastic torticollis, Botox can always help solve them. Therefore, when the first symptoms occur, you should immediately consult a doctor, as the prognosis will be as favorable as possible.
