Spasmodic Torticollis Handbook

Book excerpt: Spasmodic torticollis, also known as cervical dystonia, affects about three people in 10,000, or an estimated 85,000 individuals in the United States alone. Despite this, there has been until now a lack of information outside of the professional medical literature for use by individuals with this disorder and their families. This book provides comprehensive information on the disorder for people with spasmodic torticollis and those close to them. Medical terms and concepts are introduced sequentially and then used as building blocks for the later discussion. Beginning with a clear definition of the disorder, opening chapters categorize this neurologic disease as one of the broader category of movement disorders, and differentiate it from other conditions with which it is often confused. The authors then present a stepwise introduction to the relevant anatomy and physiology of the nervous system and neck. They draw on the experiences of their patients to build a progressive depiction of the experiences an individual might have as he or she goes through the initial onset of symptoms, progression of the disorder, seeking medical care, diagnosis, treatment, and subsequent outcome. Personal vignettes from the experiences of selected patients are provided where they illustrate particular points in the discussion. Subsequent chapters discuss various modes of treatment for spasmodic torticollis. Prior to the mid-1980?s, there were no specific treatments for this disorder. Nearly all treatment consisted of using oral medications that were primarily intended for other medical conditions. Since most of these medications are still in use, and a few new ones have been added, a chapter is devoted to detailing them and discussing the general principles of medication therapy. During the past decade, chemodenervation using botulinum toxin has become the primary and most effective treatment for spasmodic torticollis. For those few patients who require surgery, a description is provided of the neurosurgical techniques developed during the last twenty years specifically for its treatment. The final chapter is a manual of therapeutic rehabilitation exercises designed to alleviate the symptoms of spasmodic torticollis. These exercises can be performed by most patients with no assistance and a bare minimum of equipment. Since each person?s case of spasmodic torticollis is different, only certain of the exercises may be appropriate for any given individual. They should be undertaken only after discussion with your physician. These exercises are accompanied by detailed illustrations that emphasize the particular muscles relevant to each posture or movement. About the Authors: Dr. Pathak is a neurologist with a special interest in the neurologic rehabilitation of movement disorders, especially spasmodic torticollis. Dr. Frei is a neurologist specialized in the field of neurogenetics, and has conducted clinical trials on a number of movement disorders, including spasmodic torticollis. Dr. Truong is a neurologist and movement disorders specialist. He has conducted active research in the management of movement disorders, including spasmodic torticollus. He was one of the pioneers in the use of botulinum toxin to manage this condition, and has lectured worldwide on the management of movement disorders.