[Experience with stereotaxic brain surgery for spasmodic torticollis]

For diagnostic and therapeutic purposes, a differentiation of torticollis spasmodicus into horizontal, rotatory, and horizontal-rotatory forms is advisable. They are supplemented by an additional retrocollis component, by further signs of torsion dystonia, and by a pure form of retrocollis. The 24 patients treated by the authors stereotactically are classified accordingly. The stereotactic exclusion of target points in the thalamus (ventro-oral nuclei, mainly V.o.i., H1, nucleus interstitialis Cajal) brought about a removal in 20.8 per cent, considerable improvement in another 20.8 per cent, a satisfactory improvement in 16.8 per cent, and a positive effect on the wryneck symptoms in 25 per cent. In 16.6 per cent of the cases no change could be achieved. Side-effects were not observed. The recommended therapeutic order ranges from peripheral interventions (injections, separating of the muscle branch of the N. accessorius) to the stereotactic operations and finally cervical rhizotomy (in rare cases).