小结
定义
病史和体格检查
关键诊断因素
- 颈部不自主扭转或偏斜
- 颈疼痛
- 感觉假象的存在
- 异常头部姿势
- 其他神经系统检查正常
其他诊断因素
- 头部震颤
- 慢性起病
- 头痛
- 颈部肌肉的不对称性肥厚
- 颈部活动度 (ROM) 正常（病程早期）
危险因素
- 女性
- 中年（40-59 岁）
- 白人血统
- 获得性斜颈家族史
- 使用多巴胺阻滞剂
- 外伤史
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 颈部 X 光检查
- 头颅 CT/MRI
- 颈部 CT/MRI
- DYT-1 基因
- 血清铜蓝蛋白、尿铜排泄
- 肌电图
治疗流程
无疼痛或功能损害
有功能损害、疼痛或生活质量下降
肉毒杆菌毒素疗法难以治疗的病例
撰稿人
作者
David B. Sommer, MD, MPH
Neurologist and Movement Disorder Specialist
Reliant Medical Group
Worcester
MA
利益声明
DBS declares that he has no competing interests.
鸣谢
Dr David B. Sommer would like to gratefully acknowledge Dr Mark A. Stacy, a previous contributor to this topic.
利益声明
MAS has received speaking honoraria and consulting fees from Allergan, the manufacturer of Botox; he has received research grant support from Ipsen, manufacturer of Dysport, and Merz, manufacturer of Xeomin; he is an author of a reference cited in this topic. Duke University has received funding from Allergan for a continuing medical education programme.
同行评议者
Allison Brashear, MD
Professor and Chair
Department of Neurology
Wake Forest University Baptist Medical Center
Winston Salem
NC
利益声明
AB declares interests in Allergan; she is an author of a reference cited in this topic.
Robert Werner, MD
Professor
Chief of PM&R
Ann Arbor VA Medical Center
Ann Arbor
MI
利益声明
RW declares that he has no competing interests.
鉴别诊断
- 颈椎关节炎
- 颈肿块
- 脑肿块、病变或梗塞
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- EFNS 原发性肌张力障碍诊断和治疗指南
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