Abstract
Patient 1: A 6-year-old boy presented to the outpatient department for head tilt. Since the age of 2, head tilt to the right side had been noted. When he was 4 years old, cervical spine imaging was performed. Congenital laminar fusion on the right at the C2-3 vertebrae was found. At age 6, posterior in situ fusion of the C2-3 vertebrae with iliac bone graft was performed. However, head tilt was not relieved. The patient was referred to a neurologist. Examination revealed head tilt to the right with painful contraction of the neck muscles. Manual rotation of the neck to either side and straightening of the neck caused severe pain. The images obtained before and after operation were reviewed. There was an enhancing lesion anterior to atlas, axis, and C3 vertebra. It appeared to be an inflammatory lesion, whose exact etiology was not clear. Anti-inflammatory drugs and muscle relaxant were started. Painful contractions of neck muscles were somewhat reduced, resulting in mild improvement in head tilt.
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Jeon, B.S., Kim, JM. (2005). Pseudodystonic Emergencies. In: Movement Disorder Emergencies. Current Clinical Neurology. Humana Press. https://doi.org/10.1385/1-59259-902-8:111
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DOI: https://doi.org/10.1385/1-59259-902-8:111
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