Interventional muscle and nerve stimulation for spasmodic torticollis: A case report

Ahn, Kang; Jhun, Hyung Joon; Lee, Sang Chul

Case Report

General Article

Anesthesia and Pain Medicine 2010;5(3):212-215.
Published online July 31, 2010.

Interventional muscle and nerve stimulation for spasmodic torticollis: A case report

Kang Ahn, Hyung Joon Jhun, Sang Chul Lee

¹Chronic Pain Management Center, Kangnam Cha Hospital, CHA University, Seoul, Korea.
²Musculoskeletal Clinic, Department of Occupational and Environmental Medicine, College of Medicine, Korea University, Seoul, Korea. oemdoc21@gmail.com
³Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea.

Abstract

A 49-year-old woman with spasmodic torticollis was treated with interventional muscle and nerve stimulation (IMNS). Her neck was tilted to the left, and her chin was rotated and tilted to the right. Based on patient history, physical examination, and X-ray findings, the right C2-3, C3-4, C4-5 and C5-6 facet joints were selected for IMNS treatment. Under ultrasound guidance, an Ahn's Needle (a specially designed needle for IMNS) was inserted from the midline of the posterior neck and advanced toward a point over the capsule of the facet joints. The needle was moved gently forward and backward within a 1-2 mm range until no resistance was felt at the tip. After undergoing three rounds of IMNS treatment, the dystonic features were grossly normal but spontaneous activities of the muscles innervated by C6 remained. Although we did not demonstrate complete improvement of spasmodic torticollis, our report suggests that IMNS has therapeutic value for spasmodic torticollis.

Key Words: Intervention, Stimulation, Torticollis