What is the treatment for torsional spasm?

  Normally we complete a movement with one set of muscles contracting while the other corresponding set relaxes. In patients with torsional spasticity, this program of contraction and relaxation that the muscles follow consciously is disrupted and replaced by a continuous tense contraction of certain muscles, even in a quiet state.  Torsional spasticity is a common disorder in adolescents, with generalized dystonia as its typical manifestation, clinically manifested by violent, involuntary twisting of the neck, limbs, trunk or even the whole body, with hyperextension or hyperflexion of the hands and feet, usually centered on the long axis of the body. The twisting movements are often very slow and recur intermittently.  Patients with torsional spasticity commonly present with head twisted to one side when standing, shoulders tilted back, one arm extended forward and one extended backward, both knees bent inward, both feet spread apart to maintain balance, or with inward turning of the feet and inability to land completely on the soles of the feet. When lying flat, the body will be bowed, relying on the shoulders and hips for support, and some can only lie prone on the bed. Over time, some muscles may become abnormally thick and joints may become contracted and deformed. The symptoms will disappear when the patient falls asleep.  In addition, except for those with secondary torsional spasms, patients also show signs of diminished intelligence.  The current pharmacological treatment for torsional spasm is symptomatic and aims to reduce symptoms, improve function, reduce abnormal movements, and reduce pain caused by spasm, including levodopa, anticholinergic drugs, central muscle relaxants, and tranquilizers, etc. For patients with severe torsional spasm for which pharmacological treatment is ineffective, deep brain electrical stimulation surgery can be chosen. The procedure can effectively relieve the dystonia and improve the symptoms of patients with torsional spasm to a greater extent, and deep brain electrical stimulation has the advantages of being reversible and adjustable without permanent damage to brain tissue. It is especially suitable for adolescent patients whose brain development is not yet complete, and the patient will benefit from the procedure for life.