1/20. Spasmodic torticollis due to neurovascular compression of the spinal accessory nerve by the anteroinferior cerebellar artery: case report.OBJECTIVE AND IMPORTANCE: Spasmodic torticollis is a neuromuscular disorder characterized by uncontrollable clonic and intermittently tonic spasm of the neck muscles. We report a case of spasmodic torticollis attributable to neurovascular compression of the right XIth cranial nerve by the right anteroinferior cerebellar artery (AICA). CLINICAL PRESENTATION: A 72-year-old man with a 2-year history of right spasmodic torticollis underwent magnetic resonance imaging, which demonstrated compression of the right XIth cranial nerve by an abnormal descending loop of the right AICA. INTERVENTION: The patient underwent microvascular decompression surgery. During surgery, it was confirmed that an abnormal loop of the right AICA was compressing the right accessory nerve. Compression was released by the interposition of muscle between the artery and the nerve. CONCLUSION: The patient's postoperative course was uneventful, and his symptoms were fully relieved at the 2-year follow-up examination. This is the first reported case of spasmodic torticollis attributable to compression by the AICA; usually, the blood vessels involved are the vertebral artery and the posteroinferior cerebellar artery.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/20. Ptosis as a remote effect of therapeutic botulinum toxin B injection.The authors report a patient with cervical dystonia, previously treated with botulinum toxin A (BTX-A), who developed bilateral ptosis and difficulty with accommodation only after botulinum toxin B (BTX-B). High-frequency repetitive nerve stimulation of the abductor digiti minimi demonstrated a 34% increment in compound muscle action potential. No increment in 20 people injected with BTX-A and no cases of ptosis in a chart review of 1,606 BTX-A injections for cervical dystonia were found. The authors conclude that systemic spread of BTX-B can cause symptomatic involvement of autonomic neurons.- - - - - - - - - - ranking = 0.125keywords = nerve (Clic here for more details about this article) |
3/20. Traumatic occipital condyle fracture, multiple cranial nerve palsies, and torticollis: a case report and review of the literature.A 32-year-old man sustained a unique combination of injuries: an occipital condyle fracture, left tenth to twelfth cranial nerve palsies, and chronic torticollis secondary to atlantoaxial rotatory fixation. Computed tomography (CT) demonstrated a triangular fragment of bone in the posterior fossa, and three-dimensional CT-reconstructed images confirmed the bone fragment to be from the occipital condyle. The patient made a good recovery with conservative management. Few occipital condyle fractures have been reported, and they should be suspected in patients who sustain painful neck and lower cranial nerve palsy following trauma. CT and plain films are complementary in confirming the diagnosis.- - - - - - - - - - ranking = 0.75keywords = nerve (Clic here for more details about this article) |
4/20. Fatal case of BOTOX-related anaphylaxis?Anaphylactic drug reactions are rare and often serious events. The Botulinum toxin A, marketed as BOTOX, was recently approved by the food and Drug Administration for cervical dystonia and glabellar wrinkles, after its approved use and success with blepharospasm, strabismus, and disorders of the 7th cranial nerve. It has been well received due to its efficacy in improving facial lines. This case report documents the first death associated with a Botox-lidocaine mixture given to a woman for chronic neck and back pain. Based on the medical records, autopsy, and laboratory findings, the cause of death was determined to be anaphylaxis to the Botox-lidocaine mixture. The history, indications, off-label uses and possible future applications of Botox are reviewed as well as the uses and complications of lidocaine. Although the anaphylaxis cannot be definitively proven to be due to Botox alone, this case warns of an adverse reaction related to Botox, a drug that is rapidly expanding in range of use as well as increased usage.- - - - - - - - - - ranking = 0.125keywords = nerve (Clic here for more details about this article) |
5/20. Cervical dystonia following exposure to high-G forces.Injuries to the cervical region have been associated with high-G loads sustained during air combat maneuvering (ACM) in high performance fighter aircraft. The spectrum of injuries ranges from mild neck pain to musculoskeletal strain, injury to the nerve roots or spinal cord, and fracture of the cervical spine. A 36-year-old fighter pilot with 2,800 h in tactical jet aircraft developed progressive cervical dystonia (spasmodic torticollis), following an ACM flight. The patient was successfully treated with local intramuscular injections of botulinum toxin into the affected cervical muscles, resulting in total relief of his spasmodic torticollis. The aeromedical considerations of this rare complication of exposure to G forces in high performance aircraft are discussed.- - - - - - - - - - ranking = 0.125keywords = nerve (Clic here for more details about this article) |
6/20. Inflammatory torticollis in children.Acute torticollis is commonly seen in the pediatric emergency department. It often results from an inflammatory process that irritates the cervical muscles, nerves, or vertebrae. Posturing of the head occurs with unilateral spasm of the sternocleidomastoid muscle such that the child will position the head with the occiput rotated to the affected side and the chin rotated to the contralateral side. We recently treated 26 children who presented to the emergency department with acute nontraumatic torticollis. The most common causes were upper respiratory infection, sinusitis, otomastoiditis, cervical adenitis, and retropharyngeal abscess or cellulitis. Four patients had subluxation of the atlantoaxial joint as a result of the inflammatory process. Children with acute torticollis need careful evaluation for either overt or occult otolaryngologic infections. Computed tomography and magnetic resonance imaging are helpful in determining the cause of the acute torticollis and in ruling out rotatory subluxation of the atlantoaxial joint.- - - - - - - - - - ranking = 0.125keywords = nerve (Clic here for more details about this article) |
7/20. Post whiplash dystonia well controlled by transcutaneous electrical nervous stimulation (TENS): case report.It has been established that peripheral trauma can cause focal and generalized dystonias, which may be difficult to treat. The case presented of a 28-year-old with post whiplash focal dystonia shows that transcutaneous electrical nerve stimulation (TENS) may be a useful treatment in the early management of focal dystonias which fail to respond to conventional therapy.- - - - - - - - - - ranking = 0.125keywords = nerve (Clic here for more details about this article) |
8/20. torticollis following radiation therapy.A patient with adenocarcinoma in the apical portion of the lung producing a Pancoast's syndrome developed torticollis a few months after receiving a course of radiation therapy (5,040 rad) to his upper chest and neck. We describe this case, in which local radiation fibrosis of the neck muscles and perhaps segmental demyelination of the 11th cranial nerve resulted in peripheral nervous system lesion causing torticollis.- - - - - - - - - - ranking = 0.125keywords = nerve (Clic here for more details about this article) |
9/20. intervertebral disc calcification in children.Calcification of cervical intervertebral discs in children is due to an uncommon, but distinct, disease of unknown etiology. signs and symptoms of nerve root or spinal cord compression are unusual and acute symptoms are followed by a benign course and spontaneous recovery. We describe a 5-year-old patient with symptomatic cervical disc calcification and discuss the relevant clinical and radiographic features.- - - - - - - - - - ranking = 0.125keywords = nerve (Clic here for more details about this article) |
10/20. Spasmodic torticollis caused by vascular compression of the spinal accessory root.A case of spasmodic torticollis in a 27-year-old man cured by vascular decompression of the spinal accessory root, without any nerve sectioning, is presented. The nerve compression was produced by the posterior inferior cerebellar artery originating from the vertebral artery at the C-1 level, and was released by transposing the artery from the nerve root, using the divided dentate ligament. The patient was completely free from symptoms after a follow-up period of 3 years. The possible causal importance of nerve compression in spasmodic torticollis is emphasized.- - - - - - - - - - ranking = 0.5keywords = nerve (Clic here for more details about this article) |
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