Smith D L, DeMario M C
West Jersey Health System, Family Practice Residency Program, Voorhees, NJ 08043, USA.
J Am Board Fam Pract. 1996 Nov-Dec;9(6):435-41.
Spasmodic torticollis is a movement disorder of the nuchal muscles, characterized by tremor or by tonic posturing of the head in a rotated, twisted, or abnormally flexed or extended position or some combination of these positions. The abnormal posturing of the head allows this disorder to be clinically diagnosed. Psychiatric symptoms frequently accompany or precede the diagnosis of the movement disorder.
Using the key words "torticollis," "spasmodic torticollis," "therapy," "behavior therapy," "botulinum toxin," MEDLINE was searched from 1989 to 1996 for information on the cause and treatment of spasmodic torticollis.
Therapies include behavior modification, such as biofeedback, hypnosis, or simply training the patient to consciously readjust the position of the head; pharmacotherapy, using a variety of agents, the most commonly prescribed being anticholinergic medications or the botulinum toxin type A; and surgery, which entails selectively denervating the muscles responsible for the abnormal movement or posture of the head. The most effective treatments include surgery and botulinum, with sustained success rates ranging from approximately 60 to 90 percent.
痉挛性斜颈是一种颈部肌肉的运动障碍，其特征为震颤或头部处于旋转、扭曲、异常屈曲或伸展位置或这些位置的某种组合的强直性姿势。头部的异常姿势使得该疾病能够在临床上得到诊断。精神症状常常伴随运动障碍的诊断出现或在其之前出现。
使用关键词“斜颈”“痉挛性斜颈”“治疗”“行为疗法”“肉毒杆菌毒素”，检索1989年至1996年的MEDLINE，以获取有关痉挛性斜颈病因和治疗的信息。
治疗方法包括行为矫正，如生物反馈、催眠或仅仅训练患者有意识地重新调整头部位置；药物治疗，使用多种药物，最常用的是抗胆碱能药物或A型肉毒杆菌毒素；以及手术，即选择性地使导致头部异常运动或姿势的肌肉失神经支配。最有效的治疗方法包括手术和肉毒杆菌毒素，持续成功率约为60%至90%。
