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. 2019 Jul 12:9.
doi: 10.7916/tohm.v0.647. eCollection 2019.

Torticaput versus Torticollis: Clinical Effects with Modified Classification and Muscle Selection

Wolfgang H Jost  1   2
Affiliations

Torticaput versus Torticollis: Clinical Effects with Modified Classification and Muscle Selection

Wolfgang H Jost. Tremor Other Hyperkinet Mov (N Y). .

Abstract

Background: Several different subtypes are distinguished in cervical dystonia, depending on their different levels of movement. In simple rotation, classified as torticollis spasmodicus, we now differentiate between torticollis and torticaput dependent on whether only the head or the neck is turned. The new classification system permits for different injection schemes.

Case reports: In a retrospective study of 22 patients, we examined whether modifying the injected muscles leads to improvement in the results as evaluated in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). The results showed that both injection schemes do in fact lead to improvements while differentiating between caput and collum has significantly better effects.

Discussion: Due to our results we recommend the classification differentiating between torticollis and torticaput type.

Keywords: Obliquus capitis inferior; TWSTRS; Torticaput; botulinum toxin; cervical dystonia; sonography; torticollis.

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Conflict of interest statement

Funding: None. Conflicts of Interest: The authors report no conflict of interest. Ethics Statement: This study was performed in accordance with the ethical standards detailed in the Declaration of Helsinki. The authors’ institutional ethics committee has approved this study, and all patients have provided written informed consent.

Figures

Figure 1
Figure 1
Anatomy of short neck muscles. Short Neck Muscles with Marked Obliquus Capitis Inferior Muscle (with Permission of the Author and Publisher).
Figure 2
Figure 2
Torticaput vs. Toricollis. In Cases of Torticaput (on the Left), the Larynx Remains Rather More in a Medial Position, and in Torticollis (on the Right) it Rotates Laterally.
See this image and copyright information in PMC

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