Korean J Pain.  2007 Dec;20(2):246-250. 10.3344/kjp.2007.20.2.246.

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

• Choi CH
• Choi JH
• Sung CH

• KMID: 2278075
• DOI: http://doi.org/10.3344/kjp.2007.20.2.246

Abstract

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.

Keyword

accessory nerve block; selective ramisectomy; spasmodic torticollis; stellate ganglion block; sternocleidomastoid muscle resection

MeSH Terms

Accessory Nerve
Botulinum Toxins, Type A
Cervical Plexus
Humans
Nerve Block*
Spasm
Stellate Ganglion
Torticollis*
Botulinum Toxins, Type A