Research progress in spasmodic torticollis rehabilitation treatment

Spasmodic torticollis(ST)is a focal dystonia that affects adults,causing limited muscle control and impacting daily activities and quality of life.The etiology and curative methods for ST remain unclear.Botulinum toxin is widely used as a firstline treatment,but long-term usage can result in reduced tolerance and adverse effects.Rehabilitation therapy,with its minimal side effects and low potential for harm,holds significant clinical value.This article explores the effectiveness of adjunctive therapies,including exercise therapy,transcranial magnetic stimulation,shockwave therapy,neuromuscular electrical stimulation,vibration therapy,electromyographic biofeedback,and acupuncture,in the treatment of ST.The aim is to provide clinicians with additional treatment options and to discuss the efficacy of rehabilitation therapy for ST.

Massage and vocal training in a case of spasmodic dysphonia

A 35-year-old female patient with spasmodic dysphonia underwent massage and vocal training. Chinese manipulation was administered to Tiantu （CV 22） and Lianquan （CV 23）, the convergent acupoints of the conception meridian and Yin link vessel, Yamen （GV 15） and Fengfu （GV 16）, the convergent acupoints of Du meridian and Yang link vessel, as well as large intestine channel of hand Yangming Hegu （LI 4）, by gently pressing and rubbing for stimulation. In addition, throat muscle massage therapy and vocal training were performed. Results were evaluated using acoustic measurements in combination with a single statistical method. A comprehensive treatment combining vocal training and face-neck massage was shown to relieve dystonia of facial-cervical muscles in patients, as well as improve voice quality while providing a safe treatment method.

An Extremely Effective and Safe Approach of Guiding Catheter Crossing over Spasmodic Radial or (and) Brachial Artery in Patients Whose Percutaneous Coronary Intervention Was Undergone via Radial Artery Access

Objective: Percutaneous coronary intervention (PCI) via the radial artery access has more advantages than that of femoral artery access, while radial or (and) brachial artery have tendency to be spasmodic. We sought to investigate the effectiveness and safety of guiding catheter crossing over spasmodic radial or (and) brachial artery segments by the aid of PCI wire and balloon compared with traditional anti-spasmodic approach. Methods: The clinical data of 168 patients with coronary artery disease (CAD) (group A), whose PCI was performed via radial artery access with radial or (and) brachial artery spasm or (and) dissection and guiding catheter passing through spasmodic segments successfully by the aid of PCI guiding wire and balloon were analyzed retrospectively, simultaneously, the other 73 patients (group B) who used conventional approach to cross over the spasmodic radial or (and) brachial artery segments were treated as the control. The success rate, the time consumption and the complication were compared between the two groups. Findings: There was no significant difference in the spasmodic site between the two groups (all p value > 0.05). The success rate in group A was significantly higher than that in group B (168(100%) vs 28 (38.4%), p (4.2%) vs 14 (19.2%), p Conclusions: It is more effective and safer for guiding catheter crossing over spasmodic or (and) dissected radial or (and) brachial artery segments by the aid of PCI guiding wire and balloon than using the routine approach of administration of anti-spasm drugs for trans-radial PCI.

Tuina massage combined with traditional Chinese prescription improves quality of life and motor symptoms in a spasmodic torticollis patient:A case report

Objective:A case study was performed to discuss the efficacy of traditional Chinese medicine(TCM)treatments on spasmodic torticollis.Materials and methods:A 28-year-old male was diagnosed with spasmodic torticollis due to twist and turn of neck after being frightened,who was unable to take care of himself for over 3 months.He once took an oral non-steroidal anti-inflammatory drug,but no significant improvement was seen in his symptoms.After a few months,his symptoms got worse,with onset of spasms.Therefore,he was treated at our hospital with traditional Chinese prescription and Tuina massage therapy for 3 months and followed up for 6 months.The Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS)and the Craniocervical Dystonia Questionnaire(CDQ-24)scores were recorded before and after treatment and during follow-up observations to evaluate the therapeutic efficacy.Results:Compared to the baseline,the TWSTRS and CDQ-24 scores decreased significantly,and there was no evident recurrence of his symptoms for at least 6 months of follow-up.Moreover,no apparent discomfort or side effects were observed during the treatment.Conclusion:Jingu abdominal massage combined with traditional Chinese prescription has a certain efficacy in the treatment of spasmodic torticollis,with almost no side effects,which can be easily accepted by patients.

Modified Foerster-Dandy 's operation for treatment of spasmodic torticollis under endoscope-assisting

Objective To study microsurgical effectiveness Foerster-Dandy’s endoscope-assisted operation for treatment of spasmodic torticollis. Methods 183 cases of spasmodic torticollis patients were treated by microsurgical modified Foerster-Dandy’s operation from July 2001 to June 2009,which was randomly

Significance of age and sex in botulinum neurotoxin dosing for adductor spasmodic dysphonia

Objectives: This study aims to analyze the impact of age and sex on botulinum neurotoxin (BoNT-A) dosing and outcomes in adductor spasmodic dysphonia (AdSD).Methods: A database review of all spasmodic dysphonia patients treated with BoNT from 1989 to 2018 at the Mayo Clinic in Arizona was performed. Only patients who had received ≥4 injections of BoNT-A for AdSD were included. Patients were divided into two cohorts to analyze age, with an age of first treatment cutoff of 60 years. Patients were divided into male and female cohorts to analyze sex.Results: The final analysis included 398 patients. The mean dose of BoNT-A per treatment was significantly higher in the younger cohort (4.4 vs. 3.9 units,p = 0.048). The mean maximal benefit was similar (72% vs. 70%,p = 0.48);however, the mean length of benefit was significantly shorter in younger patients (3.0 vs. 3.6 months,p < 0.01). The mean BoNT-A dose was significantly higher in the female cohort (4.2 vs. 3.6 units,p = 0.02). The mean maximal benefit was similar (69% vs. 75%,p = 0.58), as was the mean length of benefit (3.2 vs. 3.5 months,p = 0.11).Conclusions: This study suggests that age and sex influence BoNT-A dosing and outcomes in AdSD.

Application effect of phloroglucinol injection in elderly patients with spastic abdominal pain in emergency department

BACKGROUND Although norepinephrine injection is commonly used in emergency situations,it is associated with risks for elderly patients with spasmodic liver pain.This study explores the safety and effectiveness of mebendazole injection,an alternative treatment option,for the emergency management of spasmodic abdominal pain,while minimizing adverse reactions,in elderly patients.AIM To explore the development of norepinephrine injection and the adverse reactions of this drug in emergency elderly patients with spasmodic liver pain.METHODS The control group consisted of 56 elderly patients visiting our hospital from January 2021 to December 2021.After hospital admission,the control group was intravenously administered tolopin.The experimental group consisted of 56 emergency patients with spasmodic abdominal pain who visited our hospital until June 2022.After hospital admission,the experimental group was intravenously administered toloxazole.The two groups were treated for 3 d.The disappearance of clinical symptoms was observed before and after the treatment,and the difference in adverse reactions between the two groups was compared.RESULTS The pain of the wife,fire,diarrhea,drowning,and surrounding time disappeared in the experimental group.No statistical difference was observed between the experimental and control groups in visual pain analog scale(VAS)scores before and after the treatment(P>0.05).The VAS scores of abdominal pain severity after 0.5 h,1.0 h,and after 6.0 h of treatment were significantly lower for the experimental group than for the control group.After the treatment,the therapeutic effect in the experimental group was higher and statistically significant than that in the control group(P<0.05).The probability of adverse reactions before the treatment was lower in the experimental group than in the control group.CONCLUSION During emergency,mebendazole injection exhibited a good therapeutic value when used for the clinical treatment of elderly patients with spasmodic stomach pain.It accelerated the disappearance of clinical symptoms such as stomach pain,reduced the stomach weight,and improved clinical activity.Reducing and promoting the frequency of high treatment safety with mebendazole injection is worthwhile.

Inpatient use of racemic epinephrine for children admitted with croup

Background Pediatric patients with croup are frequently admitted if they require two doses of racemic epinephrine(RE)in the emergency department(ED).We aimed to identify factors associated with the need for additional therapy(>2 RE doses)among pediatric patients with croup.Methods We performed a single-center retrospective study of consecutive patients admitted from the ED with a diagnosis of croup between January 1,2011 and December 31,2015.Primary outcome was need for>2 doses of RE.Secondary out-comes included time to third RE and 72-hour return visits.We performed logistic regression to identify factors associated with use of>2 RE doses during hospitalization,and survival analysis to identify time to dosing of 3rd RE from 2nd RE.Results Of 353 included admissions[250(70.8%)males,median age 1.48,interquartile range 0.97-2.51 years],106/353(30.0%)required>2 RE.In univariate logistic regression,only recent use of steroids within 1 day prior to presentation(4.18,1.48-11.83;P=0.007)was associated with need for>2 RE.Survival from third RE was 0.74(95%CI 0.69-0.78),which was similar to the survival at 12 hours(0.70,95%CI 0.65-0.75).Return visits occurred in 19(5.4%)patients,of whom 12/19(63.2%)were given RE.Conclusions Patients hospitalized for croup with recent use of steroids prior to ED presentation have a greater need for>2 RE during hospitalization.The majority who require inpatient RE will do so within 8-12 hours.These data provide informa-tion for risk stratification and duration of monitoring for patients hospitalized with croup.