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1例47岁女性患者头向左侧阵发性旋转,颈部向右侧倾斜后仰,颈部酸痛8个月。上述症状逐渐加重,失去工作。查体:颈后肌群阵发性抽搐,右侧胸锁乳突肌及斜方肌明显增粗隆起,伴有压痛,BFM运动计分8分。先行左侧GPi刺激电极植入术。术后1个月头向右侧倾斜消失,转而向左侧倾斜稍后仰。再行右侧GPiDBS植入术。术后9个月随访,头左后仰好转,仍有左侧旋转,可见右侧胸锁乳突肌痉挛增粗隆起。即用A型肉毒素50u行右侧胸锁乳突肌及斜方肌受累部分多点注射。1周后胸锁乳突肌明显变细,肌张力下降。随访3年患者头颈姿势近于正常位,BFM计分1分,能完成家务工作,可参加社会活动,患者对治疗效果满意。
A 47-year-old female patient had a paroxysmal spin on his left head, his neck tilted back to the right, and his neck sore for 8 months. The above symptoms gradually aggravated, losing their jobs. Physical examination: paroxysmal convulsion of the posterior cervical muscle group, the right sternocleidomastoid and trapezius muscle significantly increased swelling, accompanied by tenderness, BFM scoring 8 points. First left GPi stimulation electrode implantation. 1 month after the head tilt to the right disappear, turn to the left tilt later Yang. Then the right GPiDBS implantation. After 9 months of follow-up, the first left heel turned better, there is still left rotation, we can see the right sternocleidomastoid spasm thickening uplift. That type A botulinum toxin 50u right sternocleidomastoid and trabecular involvement part of the multi-point injection. One week later, the sternocleidomastoid muscle became thinner and the muscle tension decreased. After 3 years of follow-up, the position of the head and neck of the patients was nearly normal. The BFM scored 1 point to complete the housework and participate in social activities. The patients were satisfied with the treatment effect.