Clinical manifestations of spastic squint

  Spastic squint (ST) affects both men and women, and most patients have a slow onset, with aura symptoms such as stiffness, swelling and pain in the neck and pillow before the appearance of the squint, and the initial deviation is self-correcting, manifesting as paroxysmal spasms, uncontrollable back and forth jerking and tremors of the head, and the symptoms become more and more obvious with time, and walking, exertion, anxiety or irritability will aggravate the symptoms, which will be alleviated after lying down and disappear after sleeping. The patient can immediately improve the abnormal position of the head by lightly holding the skin of the jaw with one finger, and after letting go of the jaw, the symptoms are the same as before.  The incidence of this disease is about 15/300,000, mostly seen in adults, the average age of onset is 30-40 years old, and the proportion of men and women is about equal. The onset of spastic squint is slow, progressively worsening, and rarely subsides or resolves on its own. The abnormal movement of the head and neck muscles is uncontrollable, often involving bilateral muscle groups, but the degree of involvement is often asymmetrical, resulting in a twisting movement of the head to one side.  Other effective ways of relief include leaning back in a high-backed chair, holding an object in the mouth, or pulling the hair.  In the early stages of the disease, these methods are helpful for most patients, but may lose their usefulness as the disease progresses, with painful hypertrophy of the affected muscles and negative neurological findings. Spastic levator disease itself is not fatal, but it can seriously affect the quality of life, normal life of the patient.