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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Botulinum toxin A was administered to 19 patients in a double-blind placebo controlled trial. Toxin was more effective than placebo for improving both head position and pain which was measured by an objective rating scale and videofilm assessments. Following the controlled trial, treatment with botulinum toxin was continued in an open fashion. A total of 60 patients with torticollis received toxin in a total of 117 treatment periods. The mean follow up period was 8.4 months. In 39 patients with pain there was benefit in 77% of treatment periods. Some improvement in neck posture occurred in 83% of the treatment periods with a mean duration of 12 weeks. Side effects were frequent with dysphagia being the most common (28% of treatment periods). Botulinum toxin is an effective treatment for toticollis but treatment should be initiated with doses at the lower end of the range used in this study (400-600 mouse units).
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PMID:Botulinum toxin treatment in spasmodic torticollis. 221 40

Fifteen patients with spasmodic torticollis were treated with local injections of botulinum--A toxin. All the patients were followed for a period of 4 to 7 months. Thirteen out of 15 patients (86%) improved in the amount of sustained movements of torticollis. In six out of 9 patients presenting with pain complete relief was noted. Beneficial effects of botulinum toxin injections lasted from 2 to 3 months, with reproducible efficacy after repeated injections. The most frequent side effect was dysphagia, presented in 10 patients.
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PMID:Local treatment of spasmodic torticollis with botulinum toxin. 226 8

The development of child neuroses must have certain rerequisites, in particular disposition (temperamental characteristic), an adverse situation in early childhood and a provoking conflict proper or a traumatic situation. To hysterical neuroses apply similar findings as to these disorders in adults; a hysterical neuroses is not always evidence of a hysterical nature. Psychogenic disorders in children may differ, the character of these complaints is not always typical. The complexity of the diagnostic process is demonstrated on two case--histories from which it is apparent that long--term treatment and examinations in somatic departments do not rule out the detection of the psychogenic aetiology of the somatic disorder. The first case--history is that of a twelve-year-old girl treated from the age of two years with antiepileptic drugs, in recent years the condition is compensated without treatment. After a conflict with a girl friend she developed pain in the hip joint which eventually resulted in the inability of spontaneous movement. After several months hospitalization at the orthopaedic department she was transferred to the psychiatric department where after hypnotherapy the conversion syndrome receded but the patient developed another psychopathological syndrome, impaired sexual identification. The second case--history is that of a twelve-year-old boy a re-trained left-handed with manifestations of balbuties. On account of sudden manifestations of torticollis leading to prolonged absence at school he repeated the class, for another three years he was treated by neurologists without effect. After admission to the psychiatric department he was treated by psychotherapy and placebo with a marked effect.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The occurrence of less common psychogenic disorders in children]. 236 49

Injections of botulinum toxin into the main cervical muscles responsible for abnormal posture and movements in spasmodic torticollis reduced pain and attenuated dystonia for a period of 2 months on average. After several sessions 9 out of 36 patients (25 p. 100) felt they had improved by at least 50 percent, 16 (44 p.100) by 50 to 75 percent, and 6 (17 p. 100) by more than 75 percent. There were six failures.
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PMID:[Treatment of spasmodic torticollis by local injections of botulinum toxin]. 239 9

A case of giant, thrombosed, non haemorrhagic aneurysm of the distal portion of the left vertebral artery is reported. The patient came to medical attention with an acute cervical pain after a minimal cervical traumatism and a diagnosis of torticollis from rheumatologic cause was made. In fact, a few weeks before, he had suffered three episodes of right homonymous hemianopsia. Subsequently, hiccup, vomiting, orthostatic dizziness with postural hypotension appeared, suggesting a medullary lesion. CT scan showed a round, heterogeneous high-density lesion near the fourth ventricle. Angiography was normal. MRI showed an oval mass in the fourth ventricle, between the medulla and the cerebellum. Surgery found an aneurysm of the end of the left vertebral artery.
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PMID:[Giant thrombosed aneurysm of the left vertebral artery developing in the fourth ventricle]. 259 70

This self-directed learning module highlights advances in evaluation and treatment of congenital and acquired musculoskeletal disorders in the child. It is a section of the chapter on pediatric rehabilitation for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. This section contains information on alterations of limb structure and gait, scoliosis, torticollis, sports injuries and overuse syndromes, and unexplained pain in children.
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PMID:Pediatric rehabilitation. 6. Musculoskeletal and soft tissue disorders. 271 51

The first 100 patients seen in a Pain Clinic in Nigeria are analyzed and presented. There were 53 males and 45 females aged between 11 and 65 years (means 41.3 years). A variety of ailments brought the patients to the clinic, but arthritis, back pain and spasmodic torticollis were the commonest. Methods of treatment which included acupuncture, transcutaneous nerve stimulation and trigger point injections, depended on the facilities available, the level of intelligence and economic status of the patient, particularly with regard to the use of the transcutaneous nerve stimulator.
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PMID:Initial experience in a special pain clinic in Nigeria. 277

Trauma to the neck musculature and cervical spine is frequently caused by hyperextension injuries which may result in muscular spasm or rupture. Partial rupture of the sternocleidomastoid muscle with subsequent formation of a fibrotic band is an unusual cause of acute torticollis. The case of a 21-year-old man who developed an acute torticollis and cervical pain after a motor vehicle accident is presented. Computed tomography scan demonstrated 75% rupture of the left sternocleidomastoid muscle with fibrotic band replacing the absent muscle tissue. Neck range of motion was markedly decreased. The patient underwent a trial of muscle relaxants and intensive physical therapy with no significant improvement. Surgical release of the residual fibrotic band was performed, and the left deviation of the neck was reduced from 25 degrees preoperatively to 5 degrees postoperatively. With surgical release and intensive postoperative physical therapy, the patient regained full motion and strength of the cervical spine musculature.
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PMID:Acute torticollis secondary to rupture of the sternocleidomastoid. 281 60

In a double-blind trial in 21 patients with spasmodic torticollis botulinum-A toxin produced both subjective and objective improvement, including significant pain relief in 14 of the 16 patients presenting with pain. Side-effects were more frequently reported during placebo administration and no significant systemic adverse reactions were noted.
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PMID:Double-blind study of botulinum toxin in spasmodic torticollis. 287 78

Six conditions cause most of the neck pain complaints seen by primary care physicians: cervical muscle strain or sprain, torticollis, acceleration injury, myofascial pain dysfunction syndrome, and cervical osteoarthritis or rheumatoid arthritis. Most of them can be diagnosed and treated by the primary care physician. Of the more unusual causes, one should not miss a clinical fracture; a herniated cervical disc, spinal cord compression from a disc, or epidural tumor; infection of the disc or the vertebral body; subluxation of the vertebral bodies; or pain referred from the chest or mediastinal structures. MRI offers new opportunity for early diagnosis of myelopathy owing to OA or RA, vertebral osteomyelitis, and metastatic involvement of cervical vertebrae.
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PMID:Neck pain. 306 89


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