Spasmodic torticollis: medical and botulinum A toxin treatment. 1992

M C Lee
Department of Neurology, Asan Medical Center Ulsan University College of Medicine, Seoul, Korea.

The exact pathophysiologic mechanisms of spasmodic torticollis and other idiopathic torsion dystonias remain largely unknown. Thus, a variety of drugs have been used alone or in combination on an empirical basis to treat these disorders, but to date none have efficacy that is proven and consistent. The drugs in use include anticholinergics, benzodiazepines, dopaminergics and dopamine antagonists with variable degrees of clinical improvement. Botulinum toxin A injection treatment for spasmodic torticollis is safe and efficacious with minimal adverse effect. However, it is expensive and beneficial effects are short-lasting. Only when a spasmodic torticollis patient's symptoms are refractory to combined treatment, using various drugs and Botulinum toxin injections, should the patient be considered a candidate for neurosurgical procedures.

UI MeSH Term Description Entries
D010276 Parasympatholytics Agents that inhibit the actions of the parasympathetic nervous system. The major group of drugs used therapeutically for this purpose is the MUSCARINIC ANTAGONISTS. Antispasmodic,Antispasmodic Agent,Antispasmodic Drug,Antispasmodics,Parasympathetic-Blocking Agent,Parasympathetic-Blocking Agents,Parasympatholytic,Parasympatholytic Agent,Parasympatholytic Drug,Spasmolytic,Spasmolytics,Antispasmodic Agents,Antispasmodic Drugs,Antispasmodic Effect,Antispasmodic Effects,Parasympatholytic Agents,Parasympatholytic Drugs,Parasympatholytic Effect,Parasympatholytic Effects,Agent, Antispasmodic,Agent, Parasympathetic-Blocking,Agent, Parasympatholytic,Agents, Antispasmodic,Agents, Parasympathetic-Blocking,Agents, Parasympatholytic,Drug, Antispasmodic,Drug, Parasympatholytic,Drugs, Antispasmodic,Drugs, Parasympatholytic,Effect, Antispasmodic,Effect, Parasympatholytic,Effects, Antispasmodic,Effects, Parasympatholytic,Parasympathetic Blocking Agent,Parasympathetic Blocking Agents
D001905 Botulinum Toxins Toxic proteins produced from the species CLOSTRIDIUM BOTULINUM. The toxins are synthesized as a single peptide chain which is processed into a mature protein consisting of a heavy chain and light chain joined via a disulfide bond. The botulinum toxin light chain is a zinc-dependent protease which is released from the heavy chain upon ENDOCYTOSIS into PRESYNAPTIC NERVE ENDINGS. Once inside the cell the botulinum toxin light chain cleaves specific SNARE proteins which are essential for secretion of ACETYLCHOLINE by SYNAPTIC VESICLES. This inhibition of acetylcholine release results in muscular PARALYSIS. Botulin,Botulinum Neurotoxin,Botulinum Neurotoxins,Clostridium botulinum Toxins,Botulinum Toxin,Neurotoxin, Botulinum,Neurotoxins, Botulinum,Toxin, Botulinum,Toxins, Botulinum,Toxins, Clostridium botulinum
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001569 Benzodiazepines A group of two-ring heterocyclic compounds consisting of a benzene ring fused to a diazepine ring. Benzodiazepine,Benzodiazepine Compounds
D013035 Spasm An involuntary contraction of a muscle or group of muscles. Spasms may involve SKELETAL MUSCLE or SMOOTH MUSCLE. Muscle Spasm,Muscular Spasm,Spasm, Ciliary Body,Spasm, Generalized,Ciliary Body Spasm,Ciliary Body Spasms,Generalized Spasm,Generalized Spasms,Muscle Spasms,Muscular Spasms,Spasm, Muscle,Spasm, Muscular,Spasms,Spasms, Ciliary Body,Spasms, Generalized,Spasms, Muscle,Spasms, Muscular
D014103 Torticollis A symptom, not a disease, of a twisted neck. In most instances, the head is tipped toward one side and the chin rotated toward the other. The involuntary muscle contractions in the neck region of patients with torticollis can be due to congenital defects, trauma, inflammation, tumors, and neurological or other factors. Cervical Dystonia,Spasmodic Torticollis,Wryneck,Torticollis, Intermittent,Torticollis, Psychogenic,Cervical Dystonias,Dystonia, Cervical,Dystonias, Cervical,Intermittent Torticollis,Psychogenic Torticollis,Torticollis, Spasmodic
D015259 Dopamine Agents Any drugs that are used for their effects on dopamine receptors, on the life cycle of dopamine, or on the survival of dopaminergic neurons. Dopamine Drugs,Dopamine Effect,Dopamine Effects,Dopaminergic Agents,Dopaminergic Drugs,Dopaminergic Effect,Dopaminergic Effects,Agents, Dopamine,Agents, Dopaminergic,Drugs, Dopamine,Drugs, Dopaminergic,Effect, Dopamine,Effect, Dopaminergic,Effects, Dopamine,Effects, Dopaminergic
D018492 Dopamine Antagonists Drugs that bind to but do not activate DOPAMINE RECEPTORS, thereby blocking the actions of dopamine or exogenous agonists. Many drugs used in the treatment of psychotic disorders (ANTIPSYCHOTIC AGENTS) are dopamine antagonists, although their therapeutic effects may be due to long-term adjustments of the brain rather than to the acute effects of blocking dopamine receptors. Dopamine antagonists have been used for several other clinical purposes including as ANTIEMETICS, in the treatment of Tourette syndrome, and for hiccup. Dopamine receptor blockade is associated with NEUROLEPTIC MALIGNANT SYNDROME. Dopamine Antagonist,Dopamine Blocker,Dopamine Receptor Antagonist,Dopamine Receptor Antagonists,Dopaminergic Antagonist,Dopaminergic Antagonists,Antagonists, Dopamine,Antagonists, Dopamine Receptor,Antagonists, Dopaminergic,Dopamine Blockers,Antagonist, Dopamine,Antagonist, Dopamine Receptor,Antagonist, Dopaminergic,Blocker, Dopamine,Blockers, Dopamine,Receptor Antagonist, Dopamine,Receptor Antagonists, Dopamine

Related Publications

M C Lee
August 1990, Journal of neurology, neurosurgery, and psychiatry,
M C Lee
September 1988, BMJ (Clinical research ed.),
M C Lee
January 1991, Clinical and experimental neurology,
M C Lee
September 1992, Journal of the Royal Society of Medicine,
M C Lee
February 1992, The Annals of pharmacotherapy,
M C Lee
July 1988, Journal of neurology, neurosurgery, and psychiatry,
M C Lee
January 1988, Advances in neurology,
M C Lee
August 1987, The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques,
Copied contents to your clipboard!