
torticolis

torticolis, jise sookhi gardan key roop mein bhee jaanaa jaataa haye, ack behad dardanaak, dystonic sthiti haye jise ack asamanya, asmamit sir yaa gardan kii sthiti dwara paribhaashit kiya jaataa haye, joe vibhinn karanon seey hoe sakata haye. torticolis" shabd lattin shabdon "torts" seey liya gayaa haye, jiska arth haye "mudaa huaa" aur "kolam", jiska arth haye "gardan".
sabse aam mamle mein koee spasht kaaran naheen hotaa haye, aur dard aur sir ghumaane mein kathinaaee aamtaur parr kuchh dinon key baad door hoe jaati haye, yahaan taka kii vayaskon mein upchaar key binaa bhee.
sanket aur lakshan.
torticolis ack nishchit yaa gatishil jhukaav, ghoornan haye, jisamen sir aur/yaa gardan kaa jhukaav yaa vistaar hotaa haye.
torticolis key prakaar kaa varnan sir aur gardan kii sthiti key aadhar parr kiya jaa sakata haye.
inn andolanon kaa ack sanyojan aksar dekhaa jaa sakata haye. torticolis apane aap mein ack vikaar honey key saath-saath anya sthitiyon mein ack lakshan bhee hoe sakata haye.
anya sanketon aur lakshnon mein shamil hainh
kaaran.
kaee sthitiyon seey torticolis kaa vikas hoe sakata haye jisamen shamil hainh muscular fibrosis, janmajaat reedh kii asamanyata, yaa vishaakt yaa dardanaak mastishk kii chot.
ack motaa vargeekaran janmajaat torticolis aur adhigrahit torticolis key beach antar kartaa haye.
anya shreniyon mein shamil hainh
janmajaat maanspeshiya torticolis.
janmajaat muscular torticolis sabse aam torticolis haye joe janm key samay maujood hotaa haye. janmajaat muscular torticolis bachchon mein teesari sabse aam janmajaat musculluskeletal vikriti haye. janmajaat peshiya torticolis kaa kaaran spasht naheen haye. janm aghaat yaa antargarbhashayi vikriti koo gardan mein sternoclidomastoid maanspeshiyon koo nuksan kaa kaaran maanaa jaataa haye. maanspeshiyon key ootak mein anya parivartan garbh key bheetar doharaae jaane vaale sookshm aghaat yaa shareer mein calcium kii sandrata mein achaanak parivartan seey utpann hotey hain joe lambe samay taka maanspeshiyon key sankuchan kaa kaaran banata haye.
inmein seey kissy bhee tantra key parinamswarup sternoclidomastoid maanspeshiyon kaa chhota yaa atyadhik sankuchan hoe sakata haye, joe ghoornan aur paarshv jhukane donon mein apani gati kii seema koo cumm kartaa haye. sir aamtaur parr prabhaavit maanspeshiyon kii or jhukate hue paarshv mein jhukata haye aur vipareet disha kii or ghumaata haye. dusare shabdon mein, sir khud chhoti maanspeshiyon kii disha mein jhukaa huaa haye, thhodi vipareet disha mein jhukaa huaa haye.
janmajaat torticolis 1 seey 4 saptah kii umr mein prastut kiya jaataa haye, aur ack kathin dravyamaan aamtaur parr vikasit hotaa haye. iska nidan aam taur parr ultrasonography aur ack rung histogram kaa upayog karke yaa shishu kii gati kii nishkriya garbhashay grieva seema kaa mulyankan karke naidaanik roop seey kiya jaataa haye.
janmajaat torticolis baal chikitsa chikitsa mein dekhe jaane vaale adhikansh mamalon kaa gathan kartaa haye. janmajaat torticolis kii report kii gaee ghatana 0.3-2.0% haye. kabhi-kabhi ack dravyamaan, jaise kii ack sternoclidomastoid tumour, prabhaavit maanspeshiyon mein dekhaa jaataa haye. janmajaat maanspeshiya torticolis koo gardan key ack taraf sternoclidomastoid manspeshi key fibrosis anubandh dwara bhee paribhaashit kiya jaataa haye. janmajaat torticolis apane aap thheek naheen hoe sakata haye, aur isake parinamswarup plagiocephaly sahit durlabh jatilataaen hoe sakati hain. janmajaat peshiya torticolis seey judee maadhyamik jatilataon mein drishya disfunction, chehare kii vishamta, vilambit vikas, grieva parshvagooth aur kasheruki ways apakshay shamil hain joe bachche kii upasthiti aur yahaan taka kii mansik swaasthya parr bhee gambhir prabhaav daalenge.
saumya peroxismal torticolis shishuon koo prabhaavit karane vaalaa ack durlabh vikaar haye. baar-baar honey vaale hamale ack saptah taka reh sakate hain. 2 saal kii umr taka sthiti mein sudhaar hotaa haye. kaaran aanuvanshik maanaa jaataa haye.
adhigrahit torticolis.
gair-aakasmik maanspeshiya torticolis maanspeshiyon kii ainthan, aghaat, ghaav yaa garbhashay grieva kasheruka kii bimari, adenitis, tonsilitis, sandhishoth, badhee hui garbhashay grieva granthiyon, retropharyngeal phode, yaa pramastishk tumour key parinamswarup hoe sakata haye. yeh spasmodic (clonic) yaa sthaayi (tonic) hoe sakata haye. baad vaalaa prakaar pots roga (reedh kii huddy kaa tapedik) key kaaran hoe sakata haye.
aamtaur parr yeh swa-seemit roop ack anupachaarit dunt avarodhak shithilata seey sambandhit haye, joe neend key dauran daanton koo pakadkar peesane seey aataa haye. ack baar avrodh kaa upchaar hoe jaane key baad yeh poori tarah seey thheek hoe jaayega. upchaar ack avarodhak upkaran aur dunt chikitsa key santulan key saath puuraa kiya jaataa haye.
spasmodic torticolis.
 gardan kii maanspeshiyon key baar-baar honey vaale, lekin kshanik sankuchan aur vishesh roop seey sternocleidomastoid key saath torticolis koo spasmodic torticolis kahaa jaataa haye. samanarthi shabd kaaran key aadhar parr "intermittent torticolis", "cervical dystonia" yaa "idiopathic cervical dystonia" hain.
troclear torticolis.
torticolis trocklear tantrika (chauthi kapaal tantrika) koo nuksan key kaaran hoe sakata haye, joe aankh kii behtar tirchhi maanspeshiyon kii aapoorti kartaa haye. oopari tirchhi manspeshi avasaad, apaharan aur aankh key antargrahan mein shamil hoti haye. jaba trocklear tantrika kshatigrast hoe jaati haye, tou aankh koo baahar nikala jaataa haye kyonki oopari tirchha kaary naheen curr rhaa hotaa haye. prabhaavit vyakti koo drishti kii samasya hogi jaba taka kii way apane sir koo prabhaavit paksh seey door naheen karate hain, jisase aankh kaa antardrishti hoti haye aur aankh key bahirgaman koo santulit kiya jaataa haye. iska nidan bilshowski pareekshan dwara kiya jaa sakata haye, jise haid-tilt pareekshan bhee kahaa jaataa haye, jahan sir koo prabhaavit paksh kii or modd diyaa jaataa haye. ack sakaratmak pareekshan taba hotaa haye jaba prabhaavit aankh oopar uthati haye, oopar tairati prateet hoti haye.
shareer rachana vigyaan.
antarnihit shaaririk vikriti joe torticolis kaa kaaran banati haye, ack chhoti sternocladomastoid manspeshi haye. yeh gardan kii manspeshi haye joe sternum aur clavical seey utpann hoti haye aur usee taraf asthaayi huddy kii mastoid prakriya parr daalati haye. maanav shareer mein dou sternoclidomastoid maanspeshiyaan hoti hain aur jaba way donon sikudati hain, tou gardan jhuk jaati haye. inn maanspeshiyon key liye mukhya rakt aapoorti pashch dhamani, behtar thyroid dhamani, anuprasth scapular dhamani aur anuprasth grieva dhamani seey aatee haye. inn maanspeshiyon kaa mukhya antahkaran kapaal tantrika xi (sahayak tantrika) seey hotaa haye lekin doosari, teesari aur chauthi garbhashay grieva tantrikaaen bhee shamil hoti hain. inn rakt aur tantrika aapoorti mein vikriti torticolis kaa kaaran bunn sakati haye.
nidan.
torticolis vaale bachche kaa mulyankan janm key aspas kii paristhitiyon aur aghaat yaa sambandhit lakshnon kii kissy bhee sambhavana koo nirdhaarit karane key liye itihas lene key saath shuru hotaa haye. shaaririk jaanch seey pataa chalata haye kii prabhaavit maanspeshiyon key vipareet disha mein ghoornan aur jhukana cumm hoe gayaa haye. kuchh loga kahate hain kii janmajaat mamalon mein aksar sahee paksh shamil hotaa haye, lekin prakaashit adhyayanon mein isake baare mein poori sahamati naheen haye. mulyankan mein ack poori tarah seey tantrika sambandhi pariksha shamil honey chaahiye, aur koolhe aur clubfoot key vikasatmak visthaapan jaisi sambandhit sthitiyon kii sambhavana kii jaanch kii jaani chaahiye. grieva reedh kii huddy key radiograph koo spasht asthi asamanyata koo khariz karane key liye praapt kiya jaanaa chaahiye, aur yadi sanrachanaatmak samasyaon yaa anya sthitiyon key baare mein chinta haye tou aim. aar. aaee. parr vichaar kiya jaanaa chaahiye.
ultrasonography kaa upayog maanspeshiyon key ootak koo dekhane key liye kiya jaa sakata haye, jisamen cross-sectional kshetra aur maanspeshiyon kii motai nirdhaarit karane key liye ack rung histogram utpann hotaa haye.
bachchon mein ack netra-pareekshak yaa ack netra-visheshagya dwara mulyankan parr vichaar kiya jaanaa chaahiye taaki yeh sunishchit kiya jaa sakey kii torticolis drishti samasyaon (IV kapaal tantrika pakshaghat, systagmus-sambandhit "null sthiti", aadi) key kaaran naheen hotaa haye.).
torticolis key liye antar nidan mein shamil hain
vayaskata mein dikhaai dene vaale cervical dystonia koo prakriti mein idiopathic maanaa jaataa haye, kyonki vishisht imaging takneekon mein aksar koee vishisht kaaran naheen paaya jaataa haye.
upchaar.
shuru mein, sthiti kaa ilaaj shaaririk upchaaron key saath kiya jaataa haye, jaise kii tangata koo chhodane key liye khinchaav, maanspeshiyon key santulan mein sudhaar key liye vyayam koo majboot karna, aur samroopata koo uttejit karane key liye sambhalana. kabhi-kabhi ack totar lagu kiya jaataa haye. poorna swaasthya laabh aur punah praapti kii sambhavana koo cumm karane key liye upchaar kii praarambhik shuruat bahut mahatvapurna haye.
shaaririk chikitsa.
shaaririk chikitsa torticolis key gair-aakramak aur laagat prabhaavi tareeke seey ilaaj key liye ack vikalp haye. 1 varsh seey adhik ayu key bachchon mein, aakramak chikitsa aur uchit splinting key saath tanga sternoclidomastoid maanspeshiyon kii shalya chikitsa release kaa sanket diyaa jaataa haye. janmajaat peshiya torticolis mein vyaavsaayik chikitsa punarvaas avalokan, orthosis, komal khinchaav, myphasial release takneek, maataa-pitaa kii paramarsh-prashikshan aur gharelu vyayam karyakram parr dhyaan kendrit kartaa haye. jabaki baahya rogi shishu physiotherapy prabhaavi haye, maataa-pitaa yaa abhibhaavak dwara kii jaane vaali gharelu chikitsa janmajaat torticolis key prabhaavon koo ulatane mein utani hii prabhaavi haye. shaaririk chikitsak key liye yeh mahatvapurna haye kii way maataa-pitaa koo upchaar mein unaki bhoomika key mahatva key baare mein shikshit karein aur unake bachche key liye sarvottam parinamon key liye unake saath milkar ack gharelu upchaar yojana banaaen. torticolis key upchaar key liye peaty mein paanch ghatakon koo "pahali pasand key hastakshep" key roop mein maanyata dee gaee haye aur isamen gati kii gardan kii nishkriya seema, gardan aur dhad kii gati kii sakriya seema, samamit andolan kaa vikas, paryavaraniya anukoolan aur dekhbhal karane vaale kii shiksha shamil haye. chikitsa mein, maataa-pitaa yaa abhibhaavakon koo apane bachche koo inn mahatvapurna ghatakon key saath pradaan kiye jaane kii ummeed karni chaahiye, joe neeche vistaar seey samajhaaya gayaa haye. jaba maataa-pitaa dinn mein kaee baar shaaririk chikitsa abhyaas karate hain tou navjat shishuon mein paarshv gardan kaa jhukaav aur gati kii samagr seema koo jaldi seey hassil kiya jaa sakata haye.
shaaririk chikitsak koo maataa-pitaa aur abhibhaavakon koo nimnalikhit abhyaas karna sikhana chaahieh
shaaririk chikitsak aksar torticolis seey peedit bachchon key maataa-pitaa aur dekhbhal karane vaalon koo gardan kii gatividhiyon aur sthiti mein sudhaar key liye paryaavaran koo sanshodhit karane key liye protsaahit karate hain. sanshodhanon mein shamil hoe sakate hainh
manual therapy.
ack vyavasthit sameeksha, shishu torticolis kaa mukabala karane key liye herfer takneekon kaa upayog karane key sambhaavit laabhon parr gaur kiya. adhyayan mein shishu kii neend, rone aur bechaini parr herfer key prabhaav parr bhee vichaar kiya gayaa. iss sameeksha mein herfer takneekon kaa upayog karane key kissy bhee pratikool prabhaav kii soochana naheen dee gaee. yeh dikhaaya gayaa thaa kii apane dumm parr herfer takneekon kaa upayog karane seey placebo samooh seey bahut cumm yaa koee saankhyikiya antar naheen thaa. jaba herfer takneekon koo shaaririk chikitsa key saath jodaa gayaa thaa, tou akele shaaririk chikitsa key upayog kii tulanaa mein lakshnon mein badalaav aaya thaa. jaba grieva reedh koo lakshit kiya jaataa haye, tou herfer takneekon koo sir kii vishamta vaale shishuon mein upchaar kii avadhi koo cumm karane key liye dikhaaya gayaa thaa.
sookshm vartamaan chikitsa.
ack koriyai adhyayan ney haal hii mein ack atirikt upchaar pesh kiya haye jise microcrent therapy kahaa jaataa haye joe janmajaat torticolis key ilaaj mein prabhaavi hoe sakata haye. iss chikitsa koo prabhaavi banaane key liye bachchon kii ayu teen maheene seey cumm honey chaahiye aur unamen torticolis honah chaahiye jisamen poore sternoclidomastoid maanspeshiyon koo shamil kiya jaanaa chaahiye jisamen ack spasht dravyamaan aur 10 mimi seey adhik maanspeshiyon kii motai hoe. sookshm vartamaan chikitsa koshikaon mein samanya aavrittiyon koo bahaal karane key liye ootak mein sookshm vidyut sanket bhejati haye. sookshm vartamaan chikitsa poori tarah seey dard rahit haye aur bachche kewal apani twacha parr machine seey jaanch koo mahsoos curr sakate hain.
sookshm vartamaan chikitsa koo aeye. tii. pee. aur protein sanshleshan koo badhaane key saath-saath rakt pravaah koo badhaane, maanspeshiyon kii ainthan koo cumm karane aur soojan key saath dard koo cumm karane key liye socha jaataa haye. iska upayog niyamit khinchaav abhyaas aur ultrasound diethermy key alawa kiya jaanaa chaahiye. ultrasound diethermy shareer key ootakon key bheetar gaharaai seey garmi utpann kartaa haye taaki sankuchan, dard aur maanspeshiyon kii ainthan key saath-saath soojan koo cumm karane mein madad mill sakey. upchaaron kaa yeh sanyojan bachchon koo punarvaas karyakramon mein rakhe jaane kii avadhi mein ullekhaniya parinam dikhaata haih microcrent therapy 2.6 maheenon key baad poori tarah seey thheek honey key saath punarvaas karyakram kii lambai koo lagbhag aadhe mein kaat sakati haye.
lagbhag 5-10% mamle khinchaav kaa jawab dene mein whiffle rahate hain aur unhein maanspeshiyon kii shalya chikitsa kii aavashyakta hoti haye.
shalya chikitsa.
shalya chikitsa mein sternocladomastoid maanspeshiyon key dou sir mukt roop seey vichhedit kiye jaate hain. yeh shalya chikitsa cumm seey cumm aakramak hoe sakati haye aur laparoscopic roop seey kii jaa sakati haye. aamtaur parr una logon parr shalya chikitsa kii jaati haye joe 12 maheene seey adhik umr key hotey hain. shalya chikitsa una logon key liye haye joe shaaririk chikitsa yaa botulinum toxin injection kaa jawab naheen dete hain yaa jinake paas bahut hii fibrotic sternoclidomastoid manspeshi hoti haye. shalya chikitsa key baad bachche koo ack naram gardan kaa collar (jise collot cast bhee kahaa jaataa haye) pahanane kii aavashyakta hogi. 3-4 maheenon key liye ack gahan physiotherapy karyakram hoga aur saath hii gardan kii maanspeshiyon key liye vyayam koo majboot karega.
anya upchaar.
anya upchaaron mein shamil hainh
purvanuman.
naidaanik abhyaas key adhyayan aur sakshya seey pataa chalata haye kii janmajaat torticolis key mamalon key 85-90% koo shaaririk chikitsa jaise roodhivaadi upchaar key saath hull kiya jaataa haye. pahale kaa hastakshep baad key upchaaron kii tulanaa mein adhik prabhaavi aur tej dikhaaya gayaa haye. 1 maheene kii umr seey pahale ilaaj kiye gaye torticolis vaale 98 pratishat seey adhik shishu 2.5 maheene kii umr taka thheek hoe jaate hain. 1 seey 6 maheene key beach key shishuon koo aamtaur parr lagbhag 6 maheene key upchaar kii aavashyakta hoti haye. usa bindu key baad, chikitsa mein 9 maheene key karib samay lagega, aur yeh cumm sambhavana haye kii torticolis poori tarah seey hull hoe jaayega. yeh sambhav haye kii torticolis anayas thheek hoe jaae, lekin phir seey honey kii sambhavana haye. iss kaaran seey, shishuon koo unake shaaririk chikitsak yaa anya pradaata dwara unake lakshnon key thheek honey key maheenon baad punarmulyankan kiya jaanaa chaahiye.
anya janwar.
pashu chikitsa saahitya mein aamtaur parr kewal sir aur gardan key paarshv modd koo torticolis kahaa jaataa haye, jabaki manushyon mein ghoornansheel torticolis key anuroop koo sir jhukaav kahaa jaataa haye. gharelu paltu jaanvaron mein torticolis kaa sabse adhik saamana karane vaalaa roop sir jhukana haye, lekin kabhi-kabhi sir aur gardan kaa ack taraf kaa paarshv modd hotaa haye.
sir jhukaaen.
gharelu jaanvaron mein sir jhukane key kaaran yaa tou kendriya yaa paridhiya vestibular pranali kii beemaariyaan yaa gardan dard key kaaran aasan seey raahat hoti haye. gharelu jaanvaron mein sir jhukane key gyaat karanon mein shamil hainh

