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Spinal injuries
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Atlanto-axial rotatory subluxation (Figure 16.1) can result from trauma or develop spontaneously in rheumatoid arthritis. It is sometimes seen in children, following an upper respiratory tract infection.4 It presents with local pain and torticollis although symptoms in some cases may be severe. Spontaneous reduction may occur; otherwise, intervention may be needed.
Posture and orthopedic impairments
Published in Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize, Developmental and Adapted Physical Education, 2019
Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize
The head and neck may have a tendency to droop forward, and in more severe cases this deviation may result in a rounding of the shoulders and back. A forward head occurs when the neck is extended forward and downward. Torticollis is a tilting of the head to one side caused by a shortening of the sternocleidomastoid muscle that attaches behind the ear and inserts into the clavicle and sternum.
Throat
Published in Marie Lyons, Arvind Singh, Your First ENT Job, 2018
This usually occurs as a consequence of tonsillitis, but it can occur in children after lymphadenitis. There is pain in the neck and torticollis. A swelling can be felt in the neck, which is very tender. The patient is pyrexial, is often drooling and has trismus. On examination of the mouth there is the appearance of a peritonsillar abscess (if you can see that far into the mouth!).
Coincidental occurance of episodic ataxia and multiple sclerosis: a case report and review of the literature
Published in International Journal of Neuroscience, 2022
Melike Batum, Ayşın Kısabay Ak, Güldeniz Çetin, Hamide Betül Gerik Çelebi, Sırrı Çam, Hatice Mavioğlu
EA2 begins in childhood or adolescence (2–32 years), lasts hours to days and is characterized by ataxia, vertigo, and nausea. Dysarthria, diplopia, tinnitus, dystonia, hemiplegia, epileptic seizures, and headache may accompany the episodic ataxia. It has been reported that EEG examinations reveal multiple spike-and-slow-wave discharges with or without accompanying epileptic seizures in patients with EA2 [5]. Torticollis, cognitive impairment, and psychiatric disorders have also been described [6–8]. It is the most common type of hereditary episodic ataxias. The frequency of attacks ranges from once a year to four times a week. It can be triggered by stress, exercise, caffeine, alcohol, and phenytoin and fever in children [9]. There are no neurological findings between attacks in the first years of the disease. However, persistent cerebellar signs such as ataxia and nystagmus are common in the following years. On brain MRI, cerebellar atrophy is seen, especially in the vermis [6, 10].
Special features of superior oblique hypofunction due to tendon abnormalities
Published in Strabismus, 2021
Mohammed Aleassa, Alan Le, Joseph L. Demer
All patients gave prior written informed consent according to a protocol approved by the Institutional Review Board of the Redacted Institution, and in conformity with the US Health Information Portability and Accountability Act of 1996 and Declaration of Helsinki. Subjects were participants in an ongoing MRI study of strabismus by conducted the same principal investigator at the same institution from 1990 to 2019. This study includes both surface coil MRI and detailed clinical data, including clinical imaging of ocular motility in diagnostic positions and head tilts, alignment in diagnostic gaze positions by prism-cover testing, Hess screen testing where appropriate, and operative records if surgery was performed. From this database were selected seven patients who had SO hypofunction due to tendon abnormalities, but who did not exhibit MRI evidence of SO atrophy or reduced contractility. A comparison group was selected of 11 age-matched patients in whom MRI demonstrated unilateral neurogenic SO atrophy, defined as maximum SO cross sectional area less than the 25th percentile of normal 18. In the two groups, we tabulated evaluated symptoms, torticollis, heterotropia in diagnostic positions and head tilts, and fundus torsion.
Inferior oblique muscle belly transposition and myopexy for diplopia
Published in Strabismus, 2021
Pilar Merino-Sanz, Amanda Chapinal, Pilar Gómez de Liaño Sánchez, Fabio Zavarse Fadul
Diplopia resolved in 5 of the 6 cases (83.3%). One patient with a good initial result for 1 month subsequently worsened, resulting in diplopia and hypertropia in primary position (8 pd) at the end of follow-up, though this figure has to be taken into account with caution because of the variability and the difficulty of the deviation measurement. Mean final vertical deviation was 2 pd ± 3.1. Final upshoot in adduction was resolved in the six cases. Torticollis disappeared in two cases and improved from moderate to mild in two cases. Final objective and subjective torsion were not observed (Table 2). The difference between preoperative and postoperative vertical deviation was only statistically significant in right upgaze and upgaze (p = 0.003 and p = 0.04, respectively) (Table 3).