Positive Effects of Local Anesthetic Nerve Blocks for a Patient with Newly Developed Left Side Spasmodic Torticollis after Surgical Intervention of Right Side Spasmodic Torticollis: A case report.
10.3344/kjp.2007.20.2.246
- Author:
Chang Hoon CHOI
1
;
Jin Hwan CHOI
;
Choon Ho SUNG
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. chsung@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
accessory nerve block;
selective ramisectomy;
spasmodic torticollis;
stellate ganglion block;
sternocleidomastoid muscle resection
- MeSH:
Accessory Nerve;
Botulinum Toxins, Type A;
Cervical Plexus;
Humans;
Nerve Block*;
Spasm;
Stellate Ganglion;
Torticollis*
- From:The Korean Journal of Pain
2007;20(2):246-250
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We report here on a case of right side spasmodic torticollis (ST) that was refractory to botulinum toxin type A injection and medication.The patient finally underwent a selective ramisectomy with ipsilateral sternocleidomastoid muscle (SCM) resection, but the remaining symptoms slowly aggravated, and a contralateral left side SCM spasm began.As conservative therapy for reducing the spasmodic symptoms, accessory nerve block, upper cervical plexus block and stellate ganglion block were performed twice in a week.After 6 months, the spasmodic symptoms significantly decreased. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) decreased by more than 70%.After one year of serial intermittent local anesthetic blockade therapy, the patient became almost free from the original ST symptoms (TWSTRS = 1).Serial local anesthetic interventions for the ST patient may have a beneficial role on the pathological peripherocentral neural activity of the ST patient and can modulate motor-sensory integration in the patient.
