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http://dx.doi.org/10.3344/kjp.2007.20.2.246

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 -  

Choi, Chang Hoon (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea)
Choi, Jin Hwan (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea)
Sung, Choon Ho (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea)
Publication Information
The Korean Journal of Pain / v.20, no.2, 2007 , pp. 246-250 More about this Journal
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.
Keywords
accessory nerve block; selective ramisectomy; spasmodic torticollis; stellate ganglion block; sternocleidomastoid muscle resection;
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Times Cited By KSCI : 2  (Citation Analysis)
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