[Voluntary activity of the neck muscles in patients with spastic torticollis]. / Issledovanie proizvol'noi aktivnosti myshts shei u bol'nykh spasticheskoi krivosheei.

The authors investigated the characteristics of motor disorders in patients with spastic torticollis. The study involved registration of volitional tensions of the neck muscles in isometric conditions, i.e., when the patient's head was rigidly fixed with regard to the body. Using a tensometric dynamometer the following three moments of force were measured: one responsible for bending the head forward or backward; the second, for bending the head to the right or left shoulder; and the third, for turning the head round the longitudinal axis. The electrical activity of the neck muscles was recorded with the help of surface electrodes. It has been established that the development of volitional efforts by the neck muscles under isometric conditions is difficult or impossible if directed to the side where the patient's forcible turn of the head is directed.

[Electromyography in patients with spastic torticollis]. / Elektromiografiia u bol'nykh so spasticheskoi krivosheei.

The article describes the results of electromyographic examination of the muscles of the neck in 26 patients with spasmodic torticollis. Electromyography was performed before and after stereotaxic operative interventions on the nucleus of Cajal or in combination with the diencephalic structures. It is shown that electromyographic examination of patients, especially with the use of functional motor and oculomotor tests, widens essentially the possibilities of the diagnosis by facilitating the identification or specification of the predominantly involved group of muscles. The discovery of concurrent oculographic and electromyographic changes in the dominant muscles of the neck during oculomotor tests is evidence of the connection of the system of concurrent movements of the eyes and head with the motor systems participating in the pathology of torticollis. Analysis of the dynamics of electromyographic changes in patients with predominance of the tonic component in the early and late postoperative periods is indicative of gradual increase of positive changes in the motor sphere, which, evidently, is due to the dynamic reorganizations in the previously formed stable pathological system.

[Identification of nuclei of the pretectal area during stereotaxic surgery for spastic torticollis]. / Identifikatsiia iader pretektal'noi oblasti pri stereotaksicheskikh operatsiiakh po povodu spasticheskoi krivoshei.

The neurons of mesencephalic nuclear structures were studied by microelectrode techniques for functional identification of the interstitial nucleus of Cajal during 18 stereotaxic operations on patients with torticollis. It is shown that the use of microneuronography for functional identification of structures of the pretectal region and mesencephalic structures bordering it is promising. The functional cellular complexes of these structures which respond selectively to voluntary movements of the eyes and head, rapid voluntary movements of the eyes, fixation and maintenance of the gaze, and combined movements of the eyes and head are characterized for the first time. In comparison with intracerebral radiological guiding points, the registration of these data makes possible intraoperative active search for functional neuronographically identified zones linked with the pathological mechanisms of torticollis and the performance of selective destruction with minimum volume of damage.

[Stereotaxic destruction of the interstitial nucleus of Cajal on spastic torticollis]. / Stereotaksicheskaia destruktsiia interstitsial'nogo iadra Kakhala pri spasticheskoi krivoshee.

Intraoperative clinical effects and the results of destruction were demonstrated in 31 patients with various forms of torticollis spastica subjected to operation on the interstitial nucleus of Cajal. The intraoperative clinical complex of symptoms was formed of changes of the toxic and clonic activity of the neck muscles and transient oculomotor and vestibular signs. The favourable postoperative results are evidence of the direct relation of the nuclear structures in the region of the posterior commissure to the mechanisms regulating the posture of the head and neck. Their exclusion may be one of the components of surgical correction of motor abnormalities in patients with torticollis spastica. These operations are more effective in the tonic form of the disease and in prevalence of the rotatory component in the impaired posture of the head.