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Related Experiment Videos

Posttraumatic painful torticollis.

Daniel S Sa1, Angela Mailis-Gagnon, Keith Nicholson

  • 1Movement Disorders Unit, Toronto Western Hospital, University of Toronto, Ontario, Canada.

Movement Disorders : Official Journal of the Movement Disorder Society
|December 16, 2003
PubMed
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Posttraumatic cervical dystonia (PTCD) involves rapid onset of severe pain and fixed abnormal posture after injury. Psychological factors appear crucial in its development and maintenance, suggesting a need for new terminology.

Area of Science:

  • Neurology
  • Psychiatry
  • Trauma Medicine

Background:

  • Posttraumatic cervical dystonia (PTCD) is characterized by abnormal neck/shoulder posturing after local injury.
  • A distinct subgroup exhibits rapid onset, severe pain, and fixed postures, differing from idiopathic cervical dystonia.

Purpose of the Study:

  • To further clarify the nature of posttraumatic cervical dystonia.
  • To investigate the role of psychological factors in patients with PTCD.

Main Methods:

  • Evaluated 16 patients with PTCD following trauma (e.g., motor vehicle accidents).
  • Assessed clinical features, response to intravenous sodium amytal and general anesthesia, and psychological evaluations.

Main Results:

Related Experiment Videos

  • Patients presented with rapid-onset, painful, fixed head tilt/shoulder elevation, often with sensory loss and limb weakness.
  • Psychogenic movement disorder features were noted in some cases (tremor, jaw dystonia).
  • Intravenous sodium amytal and general anesthesia showed significant improvement in posture, pain, and range of motion.

    • Conclusions:

    • Psychological factors (conflict, stress) likely play a significant role in the etiology or maintenance of PTCD symptoms.
    • The findings suggest a need to reconsider the classification of PTCD, proposing
    • posttraumatic painful torticollis
    • pending further understanding of its pathogenesis.