The Southern General in Glasgow run a Botulin injection clinic.  I have had
a few patients treated by this method with mixed results.  By coincidence
one of the patients was in today and mentioned that it had been a complete
success.  She was very pleased and thought that I would like to know that
something had worked.  I expect this means that everything else I do for her
is a complete waste of time.

-----Original Message-----
From: [log in to unmask] <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>; [log in to unmask]
<[log in to unmask]>; [log in to unmask]
<[log in to unmask]>
Date: 11 February 1998 15:37
Subject: torticollis


To the GP-UK and Evidence based medicine Lurkers

I've got a 45 yr old Barrister who has very impressive spasmodic
torticollis, except that it isn't spasmodic in frequency.. she has
had it for 6 years continuoulsy. Came on out of the blue one day. She
now looks permanently to the left and has a most impressive
hypertrophied sternomastiod muscle a la schawerzeneger.
So far

Physio
Cranial Osteopathy
Acupuncture
NSAIDs
"Normal " Osteopathy

All to no avail
Neurologist says it is Basal Ganglia problem and discharged her (?)

This year it has been much more painful. The Judge has been
commenting on why she won't look at him as well!!
Any way she is now not surprisingly perhaps, clinically depressed.

She is prepared to see anyone anywhere privately. Anyone know of
anyone who can help..I seem to remember botulinum toxin injections
from an MCQ I got wrong once, and also that congenital torticollis
gets operated on fairly early on in kids.

For the EBMers out there with access to Sacketts CATs etc.. what is
the evidence for the latter two approaches being successful?

TIA
Mark O'Connor




Dr Mark O'Connor, GP Long Ashton, Bristol
Tel:01275 392 134
Fax:01275 394 576
http://freespace.virgin.net/mark.oconnor/
Member BHIA





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