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KMID : 0363120070200020246
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Korean Journal of Pain
2007 Volume.20 No. 2 p.246 ~ p.250
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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-
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Choi Chang-Hoon
Choi Jin-Hwan
Sung Choon-Ho
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Abstract
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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.(Korean J Pain 2007; 20: 246-250)
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KEYWORD
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accessory nerve block, selective ramisectomy, spasmodic torticollis, stellate ganglion block, sternocleidomastoid muscle resection
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