11/63. Delayed recognition of a vascular complication, carotid artery aneurysm, 60 years after operation for muscular torticollis. A case report.An extremely rare vascular complication, carotid artery aneurysm, developed 60 years after a torticollis operation. The patient's internal jugular vein was completely obstructed proximal to the subclavian vein. There was an associated incomplete obstruction of the ipsilateral common carotid artery on the right aspect of the neck--the site where resection of the whole sternocleidomastoid muscle had been performed when she was one year old. The patient had audible bruits over the right common carotid at the base of her neck but no signs of occlusive cerebrovascular disease. The diagnosis was made mainly with use of technetium radionuclide angiography. To the authors' knowledge, this is the first such report in the English or German literature.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
12/63. Cervical dystonia mimicking dropped-head syndrome after radiotherapy for laryngeal carcinoma.We report a case of cervical dystonia mimicking dropped-head syndrome (DHS) in a 57-year-old man treated for laryngeal carcinoma by radiotherapy (74.4 Gy) 3 months before. Cervical computerized tomographic scan and magnetic resonance imaging (MRI) did not find any muscle fat changes but found a high-intensity signal on T2 weighted images in the cervical spinal cord. Clinical and electromyographic findings were consistent with cervical dystonia. A trapezius biopsy was normal. Spontaneous remission of the dystonia was observed for 1 month whereas the laryngeal carcinoma progressed. The link between cervical dystonia and radiotherapy might be acute radiation-induced damage to the cervical spinal cord.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
13/63. torticollis in an infant caused by hereditary muscle aplasia.torticollis is a common condition presenting to the general or pediatric orthopedist. We describe the case of a child with severe torticollis caused by a hereditary unilateral absence of the sternocleidomastoid and trapezius muscles. Both his father and paternal grandfather had a forme fruste, with similar but milder findings. electromyography and cross-sectional imaging were valuable in making the diagnosis. We believe this is the first reported case of hereditary unilateral muscle aplasia presenting as torticollis in an infant.- - - - - - - - - - ranking = 6keywords = muscle (Clic here for more details about this article) |
14/63. eosinophilic granuloma of the atlas presenting as torticollis in a child.STUDY DESIGN: This report describes a case of successful surgical treatment of eosinophilic granuloma of the atlas in a 3.5-year-old boy who presented with torticollis. OBJECTIVE: The purpose of this report was to illustrate the rare clinical presentation of eosinophilic granuloma in the atlas. SUMMARY OF BACKGROUND DATA: eosinophilic granuloma, a benign solitary lesion that commonly affects children, has a variable clinical course. Although eosinophilic granuloma has been reported to occur in the cervical spine, there have been only five reported cases of eosinophilic granuloma affecting the atlas. The management of eosinophilic granuloma ranges from observation and immobilization of the cervical spine to surgical excision. methods: The tumor was located on the left lateral mass of the atlas. biopsy and curettage were performed through an oblique incision through the posterior border of the sternocleidomastoid muscle. A histopathologic evaluation confirmed the diagnosis of eosinophilic granuloma. RESULTS: The patient tolerated the procedure with no complications, and his torticollis has completely resolved. CONCLUSION: eosinophilic granuloma of the atlas initially presented in this patient as torticollis. biopsy for confirmation of diagnosis and curettage for treatment provided a successful outcome in this patient. We suggest biopsy of the lesion and histopathologic evaluation to confirm the diagnosis in atypical cases.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
15/63. Computed tomographically-controlled injection of botulinum toxin into the longus colli muscle in severe anterocollis.We report on a 44-year-old man who suffered from severe anterocollis. Repeated computed tomographically controlled injections of botulinum toxin into the right longus colli muscle allowed a precise location of the needle and injection of the toxin, leading to clear improvement of symptoms.- - - - - - - - - - ranking = 5keywords = muscle (Clic here for more details about this article) |
16/63. The Canadian multicenter trial of pallidal deep brain stimulation for cervical dystonia: preliminary results in three patients.OBJECT: deep brain stimulation (DBS) of the globus pallidus internus (GPi) is beneficial for generalized dystonia and has been proposed as a treatment for cervical dystonia. The Canadian Stereotactic/Functional and movement disorders Groups designed a pilot project to investigate the following hypothesis: that bilateral DBS of the GPi will reduce the severity of cervical dystonia at 1 year of follow up, as scored in a blinded fashion by two neurologists using the Toronto Western Spasmodic torticollis Rating Scale (TWSTRS). Secondary outcome measures included pain and disability subscores of the TWSTRS, Short Form-36 quality of life index, and the Beck depression Inventory. methods: Three patients have undergone surgery in Calgary with a follow-up duration of 7.4 /- 5.9 months (mean /- standard deviation). One patient underwent inadvertent ineffective stimulation for the first 3 months and did not experience a benefit until DBS programming was corrected. All three patients had rapid response to stimulation, with the muscles relaxing immediately and abnormal movements improving within days. Total TWSTRS scores improved by 79%, and severity subscores improved significantly, from 15.7 /- 2.1 to 7.7 /- 2.9 (paired t-test, p = 0.02). pain and disability subscores improved from 25.5 /- 4.1 to 3.3 /- 3.1 (paired t-test, p = 0.002) and from 13.3 /- 4.9 to 3.3 /- 4.2 (paired t-test, p = 0.06), respectively. CONCLUSIONS: Although it is too early to reach broad conclusions, this report of preliminary results confirms the efficacy of DBS of the GPi for cervical dystonia.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
17/63. Infantile fibromatosis of the sternocleidomastoid muscle mimicking muscular torticollis.Infantile fibromatosis is a rare entity in children. Although the cervical region is one of the frequent sites of location for this tumor, the diagnosis may be delayed if it occurs in a usual location for a well-known entity, such as muscular torticollis or fibromatosis colli. The authors present an infant with infantile desmoid fibromatosis of the sternocleidomastoid muscle, which has been considered initially as olive of muscular torticollis.- - - - - - - - - - ranking = 5keywords = muscle (Clic here for more details about this article) |
18/63. natural history of posttraumatic cervical dystonia.We studied a case series of 9 patients with posttraumatic cervical dystonia, in whom involuntary muscle spasms and abnormal head postures occurred within 7 days after cervical injury. patients were examined, treated with botulinum toxin as necessary, and were followed up to 5 years. Based on our observations of these cases, we propose that complex regional pain syndrome (CRPS) could represent a variant of posttraumatic cervical dystonia that may develop over time after the initiation of dystonia.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
19/63. Facial scoliosis from sternocleidomastoid torticollis: long-term postoperative evaluation.A 10-year-old girl with congenital torticollis was treated by biterminal tenotomy of the sternocleidomastoid muscle and division of cervical fascia. She was followed up regularly for 14 years and her facial asymmetry resolved almost completely.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
20/63. Cervical dystonia responsive to acoustic and galvanic vestibular stimulation.We examined the effects of acoustic and galvanic vestibular stimulation in a patient with cervical dystonia. acoustic stimulation consisted of three conditions: "baseline" (no stimulation), "vestibular" (500 Hz bone-conducted tone bursts), and "control" (5,000 Hz tone bursts). Rectified electromyographic activity in the sternocleidomastoid was measured. Galvanic stimulation (1.5-2.5 mA current steps) was delivered to the mastoids, and head acceleration was measured. Vestibular acoustic stimulation reduced neck muscle activity between 16% and 44% (P < 0.001), and galvanic stimulation reduced head acceleration by 22.5% (P = 0.028). The patient reported subjective improvement in head control. Vestibular stimulation can reduce neck muscle activity in cervical dystonia and give symptomatic relief.- - - - - - - - - - ranking = 2keywords = muscle (Clic here for more details about this article) |
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