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Torsion dystonia

Torsion dystonia is a disease characterized by a violation of muscle tone and a kind of movement disorders.

The basis of the disease is the defeat of the subcortical cells of the brain and the dentate nucleus of the cerebellum . Most often, the disease is observed in the form of isolated cases, but a genetically determined predisposition is also established: sometimes members of the same family are sick with torsion dystonia.

Slow tonic spasms are observed in the muscles of the trunk and extremities, leading to a curvature of the body according to the type of rotation around the longitudinal axis (torsion spasm , rotational spasm). These cramps (see) encompass the muscles of the back, neck, torso, pelvic girdle and extremities, leading to bizarre postures in which the curvature of the back develops, the trunk is bent to the side or forward, the head is thrown back, the arms are pulled back or are forced to the body . These violent muscle spasms - hyperkinesis (see) occur paroxysmally and sharply intensify with every attempt to move, with the result that patients with great difficulty walk and even stand. At rest, convulsions diminish and disappear in sleep. All other functions of the nervous system and psyche remain completely intact.

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The disease usually begins at a young age (10-15 years) and progresses steadily. In addition to generalized forms, there are also local forms of torsion dystonia, in which spasms cover isolated neck muscles - spastic torticollis (see) or of one limb, simulating writing spasm (see). Local torsion dystonia begins at a later age and proceeds more easily.

Sometimes convulsions such as torsion dystonia can be a manifestation of not an independent disease, but a symptom of other diseases: epidemic encephalitis (see), hepato-lenticular degeneration (see), brain tumors.

Diagnosis, especially differential, is very difficult and sometimes it is set only pathologically anatomically.

The prognosis is unfavorable: the disease is slowly but steadily progressing.

Treatment . They are prescribing muscle relaxants (mellichtin), anticholinergic drugs (metamizil), adrenoblockers (ornid, aldomet), but they do not always give a positive effect and in such cases surgical treatment is carried out - destruction of subcortical structures (see Stereotactic Method). In local forms of torsion dystonia, surgical intervention can be applied on peripheral nerves (see Neurotomy, Radicotomy ).