50 year old Male patient with complains of involuntary rotation of cervical spine towards left since 9 months. Diagnosed as cervical spondylosis. Assessment shows weakness of trapezius and ipsilateral SCM. Even extensor weakness is there. No tingling or radiculopathy

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Hello Dr. Aditya hope u r doing well. As u posted I rd ur case it is interesting can u please tell me that the contraction is sustained type or it continuous type. if the contraction.is continuous type it can be balismic disorder or can be Huntington disease with vitiligo.Kindly consult with a neurologist. what are the other finding if u have please post that.

Hi sir... I have asked him to consult a neurologist or a physician... Sir I didn't find any abnormal involuntary movements... It was just rotation movement.
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This problem could be related to cord compression as spinal root of accessory emerges from upper cervical segments do CT and look for froin syndrome try decompressing may be osteophyte from vertebra could compress the cord

hello sir.. i really appreciate your approach for this patient..but sir,if their is compression of cord or roots definitely some neurological deficit would b their. if it is more upper cervical.. it could cause headache and VBI etc.
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Torticolitis, it's neck muscles spasm, advised anti spasmodics.

Pls.Order an MRI CS ...To get a clear picture*This is indeed interesting...We should request..Neuro and Spine Surgeons for their opinion and guidance...

Cervical dystonia, laterocollis. Needs Botulinum toxin inj intermittently

chronic wry neck

It's not wry neck
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must b cervical dystonia due to upper motor neurone affection. refer for ct and mri.find out history I mean proper history.

Thank you Mam... Actually the patient came to me without any papers and the case is undiagnosed.
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Either it is extrapyramidal effect of drug

sir.. its chronic wry neck...definitely Rt side muscles will be tight like scm,traps and scalene muscles. it may be because of some injury, postural and occupational. This condition is treated with stretching to release tightness of rt side muscles, strengthening exercises to improve muscular balance of Left side, and handling to stimulate symmetry. A TOT Collar is sometimes applied.

I am not able to upload the video... The spine goes into rotation involuntary... Rotation n side Flexion is not the deformity
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investigate for multiple sclerosis as there is extensor weakness

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