Sims Anthony B, Stack Brendan C, Demerjian G Gary
Cranio. 2012 Jul;30(3):188-93. doi: 10.1179/crn.2012.029.
Spasmodic torticollis or cervical dystonia (CD) is the most common form of focal dystonia and is characterized by sustained abnormal muscle contractions in the head and neck area resulting in abnormal positioning or posturing of the head. The dystonic muscle spasms associated with spasmodic torticollis may affect any combination of neck muscles. Three cases are reported of spasmodic torticollis that were treated by a dental appliance with individual varying occlusal heights to open the maxillomandibular vertical dimension. Upon increasing the vertical dimension of occlusion, there was a slowing and/or discontinuance of the symptoms of cervical dystonia. The proposed hypothesis for this reversal is that there may be neuritis of the auriculotemporal branch of the trigeminal nerve, which has direct input into the reticular formation (RF), and it may activate the cells of the pontine region of the RF known for the control and deviation of head posture. There is growing clinical evidence that temporomandibular joint (TMJ) dysfunction may be a factor in this neurological and painful disorder when it coexists.
痉挛性斜颈或颈部肌张力障碍（CD）是局限性肌张力障碍最常见的形式，其特征是头颈部区域持续出现异常肌肉收缩，导致头部异常定位或姿势。与痉挛性斜颈相关的肌张力障碍性肌肉痉挛可能影响颈部肌肉的任何组合。本文报告了3例痉挛性斜颈患者，采用具有不同咬合高度的牙科矫治器来打开上颌下颌垂直距离进行治疗。随着咬合垂直距离增加，颈部肌张力障碍症状出现缓解和/或停止。对于这种逆转现象提出的假设是，可能存在三叉神经耳颞支神经炎，该神经直接传入网状结构（RF），并且可能激活RF脑桥区域中已知用于控制头部姿势和头部偏斜的细胞。越来越多的临床证据表明，颞下颌关节（TMJ）功能障碍在与该神经和疼痛性疾病共存时可能是一个因素。
