Massage technique torticollis in children

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Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. The frequent abnormal posturing and twisting can be painful, and the functional impact of dystonia can vary from barely noticeable to severely disabling. Psychological counseling and participation in support groups are vital adjuncts to medical and physical approaches in the multidisciplinary management of dystonia.

Surgical options for intractable dystonias include altering the location or length of problematic muscles, but this is rarely successful. Thorough neurologic, physiatric, neuropsychologic, and physical therapy evaluations are important prior to consideration for surgery. Because of the risk of significant comorbidity, surgical approaches are reserved for patients with disabling dystonia in whom other treatment modalities have been exhausted. Patient education For patient education information, see Torticollis. Because each type of dystonia is treated in a different manner, the distinction between the various types is therapeutically important. Primary, or idiopathic, dystonias can present in a sporadic, autosomal dominant, autosomal recessive, or X-linked recessive manner.

Heritable childhood-onset dystonia is particularly common among Ashkenazi Jewish people. Identification of more dystonia genes may lead to better understanding and treatment of these largely nondegenerative disorders. Cervical dystonia, or torticollis, is the most common focal dystonia. Pseudodystonia Pseudodystonia encompasses a group of movement disorders that may express dystonialike movements as one of the clinical features of a syndrome.

Sandifer syndrome, stiff-man syndrome, and Isaacs syndrome may fall into this category. It has an insidious onset in people aged 30-50 years, although it can begin earlier. Intermittent spasms of the neck muscles or abnormal head movements occur because of contractions of the sternocleidomastoid, trapezius, and posterior cervical muscles. The patient may display more than 1 of these head movements simultaneously.