DEAR DR. DONOHUE: My 26-year-old grandson has been diagnosed with torticollis. Please share information about his condition and its treatment. — E.S.
ANSWER: Torticollis is a twisting of the neck. The head is bent to the side, the front or the back. It’s one of the dystonia illnesses. Dystonias are a group of illnesses where involuntary and forceful muscle contractions contort body parts into sometimes painful and always abnormal postures. Your grandson’s dystonia is limited to his neck muscles.
The cause of most dystonias is unknown. However, treatments are available. Injections of Botox into the contracting muscles can relax them for months at a time. Baclofen and clonazepam are examples of oral medicines that might stop the contractions. There are others. Deep brain stimulation, sometimes used for Parkinson’s disease, is another treatment. Selective surgery is another way to free a person from the grasp of dystonia.
Dystonias are more common than readers realize. Eyelid dystonia — blepharospasm — causes constant blinking to the point that, at times, a person is virtually blind. Musicians have had to contend with dystonias of the hands and fingers that have put their careers in jeopardy.
Your grandson will do himself a huge favor by contacting Spasmodic Torticollis/Dystonia. It’s a foundation dedicated to spreading information on this malady and helping its victims obtain the best and latest treatment. He can find the foundation on the Internet at www.spasmodictorticollis.org. Its toll-free number is 888-445-4588.
DEAR DR. DONOHUE: I am 77, and I have just been in the intensive-care unit for six days because of pericarditis. I was put on ibuprofen. Can you provide some explanation of this illness? — J.C.
ANSWER: The heart sits in a two-layered baggie, the pericardium. It holds the heart in place. Between the two sheets of pericardium is a space containing a small amount of fluid, which allows frictionless gliding of the two sheets when the heart contracts and expands.
Pericarditis is an inflammation of the adjacent surfaces of the pericardium. The inflammation produces chest pain, usually described as sharp and stabbing. Coughing, turning the chest or lying down worsens the pain. Sitting up and leaning forward relieves it. An EKG shows changes that are typical for pericarditis.
Eighty percent of the time, the cause of pericarditis is a virus. Bacterial infections, tuberculosis, cancer and illnesses like rheumatoid arthritis and lupus account for the other 20 percent of causes.
Anti-inflammatory drugs such as your ibuprofen are often the only medicines needed to quiet pericarditis. For a few patients, however, the illness relapses over and over, and stronger medicines have to be used.
In an even smaller number of patients, the inflammation leads to a discharge of fluid in the pericardial space. That, in turn, can press on the heart and interfere with blood pumping. In those instances, the fluid has to be removed.
It appears that neither complication of pericarditis has happened to you.
DEAR DR. DONOHUE: In my 39 years of practicing dentistry, I have seen many patients — including my wife — who are able to avoid aphthous mouth ulcers (canker sores) by not using toothpaste that contains sodium lauryl sulfate.
Most major brands contain it. With a little searching, people can find brands that do not. — J.F.B, DDS
ANSWER: Thank you so much, doctor. Readers and I greatly appreciate you taking the time to write. Those suffering from canker sores will appreciate your words even more.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.