Refractory cervical dystonia, unresolve issue and therapeutic challenge: Follow-up of a case with surgical denervation combined with conservative treatments

Cervical dystonia is the most common focal dystonia affecting adults. It frequently causes postural control problems, neck pain and spasm attacks of the cervical musculature. One of the surgical options available is selective cervical denervation. We report the case of a 32-year-old patient with cervical dystonia refractory to conservative treatment and an injection of botulinum toxin A, which was finally completed by bilateral selective cervical denervation, with considerable regression of cervical spasm at 16 months post-operatively.The clinical presentation of cervical dystonia includes abnormal movements or postural changes of the head, neck and shoulders caused by involuntary contractions of the cervical muscles. When the spasmodic attacks are recurrent, they can cause real handicaps for the patient. The causes of the disease and its pathophysiological mechanism are still poorly understood. There are a number of treatment options, including pharmacological therapy and surgery in cases of therapeutic failure. Repeated intramuscular injections of botulinum toxin are the first-line treatment. Some conservative measures such as physiotherapy are also used, although there is little literature on these approaches.Selective peripheral denervation is currently the main surgical treatment for refractory cervical dystonia. A combination of conservative treatment with BT-A injection and denervation appears to be an effective treatment option

Tech Neck Syndrome: A global epidemic of the modern era among students at the University of Abomey Calavi in Benin

Context and Objective: “Tech neck” is a recent term used to describe neck pain related to smartphone use. It is a health problem that has been increasing considerably since the last decade. The objective of this study was to determine the prevalence of Teck Neck syndrome among young students at the University of Abomey Calavi, in order to highlight the different factors that contribute to the occurrence of this condition. Patients and Method: This is a prospective descriptive study with consecutive sampling conducted over a period of 3 months. The study involved 1,835 young students at the University of Abomey Calavi in Benin, 850 of whom had symptoms of Tech Neck.Epi Data 3.1 software was used for data entry and R software for statistical analysis. Proportions were calculated for qualitative variables. Quantitative variables were expressed as mean ± standard deviation. The Wilcoxon test was used to compare means. The significance level was set at risk alfa = 0.05. A p-value < 0.05 was considered statistically significant. Results: For 421 (49.52%) of the participants, their symptoms would be caused by prolonged neck flexion when writing messages. Of the 1835 students, 1368 (74.55 %) reported constant communication by telephone message. In this study, 55.91 % and 89.43 % of participants respectively stated that they could not determine how often they handled their smartphone within 1 h and 24 h. None of the participants kept their neck straight when writing a message. Conclusion: The Tech neck syndrome is a health problem that has increased considerably over the last decade, especially among students, due to the misuse of NICT