Edwards L L, Normand M M, Wszolek Z K
University of Rochester, Strong Hospital, NY, USA.
Nebr Med J. 1995 May;80(5):109-15.
Cervical dystonia, although rare in the general population, can severely affect the lives of those afflicted with the disease. Throughout history several theories have been proposed regarding its etiology and pathophysiology, from underlying mental disorders to post-infectious to altered basal ganglia and brainstem function. However, CD remains poorly understood. Because of its similarity to Idiopathic Torsion Dystonia a genetic basic is suspected, but is not proven. Without a true understanding of the disease treatment remains symptomatic, and begins with physical therapy and medications and progresses to consideration of surgery. These treatment strategies have provided some relief, which is usually less than satisfactory within a short period of time. Recently, the use of botulinum toxin has provided significant symptomatic relief of pain in CD and has been associated with subjective and objective improvement in head posture. This newest therapy, although symptomatic, restores a more normal head posture and pain relief enabling the individuals with CD to continue to be active and productive participants in life, providing a ray of hope to these people as we continue to search for a better understanding of the disease process and the development of more effective treatment strategies.
颈部肌张力障碍在普通人群中虽罕见，但会严重影响患者的生活。纵观历史，关于其病因和病理生理学提出了多种理论，从潜在的精神障碍到感染后因素，再到基底神经节和脑干功能改变。然而，人们对颈部肌张力障碍仍知之甚少。由于它与特发性扭转性肌张力障碍相似，怀疑有遗传基础，但尚未得到证实。由于对该疾病缺乏真正的了解，治疗仍以对症治疗为主，首先是物理治疗和药物治疗，然后才考虑手术治疗。这些治疗策略虽能提供一定缓解，但在短时间内通常效果不尽人意。最近，肉毒杆菌毒素的使用为颈部肌张力障碍的疼痛提供了显著的对症缓解，并与头部姿势的主观和客观改善相关。这种最新的治疗方法虽然是对症治疗，但能恢复更正常的头部姿势并缓解疼痛，使颈部肌张力障碍患者能够继续积极有效地参与生活，在我们继续努力更好地理解疾病过程并开发更有效治疗策略的过程中，为这些患者带来了一线希望。
