頸部および体幹に偏倚を認めた薬剤性ジストニアに対する1回の鍼治療効果

抄録

I report acupuncture treatment for abnormal neck posture and deviation of trunk in a patient with drug induced dystonia.The patient was a 60-year-old female. In the last 3 years, her neck and mouth had showen involuntary movement when she received medical treatment for her bipolar disorder, and she was diagnosed as having drug induced dystonia. Her symptoms were slightly improved by botulinum therapy (BTX) and transcranial magnetic stimulation (TMS), but she wanted to receive acupuncture treatment, so she came to our clinic. At the first consultation at our clinic, her neck posture in a sitting position showed left lateral bending, left rotation, flexion, and extension, and her trunk posture showed left lateral bending. Her neck presented with intermittent involuntary movement of left rotation and extension. The problems of her abnormal posture were some muscle tones and shortening of skin and muscles. Abnormal muscle tones were hypertonus of the trapezius muscle and erector spinae, and hypotonus of the abdomen muscles. Skin and muscle shortening presented on the posterior region of her neck (trapezius and splenius capitis muscle), the occipital region of the head, and the interscapulum, lumbar and dorsal. Her neck also showed intermittent involuntary movement. The acupuncture treatment was as follows: multiple epidermis penetrating needles were used to treat skin and muscle shortening on the posterior region of her neck (trapezius and splenius capitis muscle), occipital region of head, and interscapulum. Lumbar and dorsal retaining needles were used for Waiguan(TE5) for hypertonus of trapezius muscle, Chongyang(ST42) to increase abdomen muscles, Kunlun(BL60) for hypertonus erector spinae, and Baihui(GV20) to decrease the involuntary movement. After acupuncture treatment, the patient's involuntary movement of the neck was reduced, and flexion of trunk and extension of neck were improved. Currently there is no definitive treatment method for drug induced dystonia. This case suggests that abnormal neck posture and deviation of trunk in a patient with drug induced dystonia can be improved by acupuncture treatment.