[Spasmodic torticollis, substantiating Manto syndrome, of possible toxic aethiology, with alterations of brainstem acoustic evoked potentials (BAEPs). Treatment with L-5-hydroxytryptophan. Follow up of 18 months, during which high degree resolution of symptoms and normalization of BAEPs took place].
A case of very severe spasmodic torticollis observed for 18 months is presented and discussed. Head was so rotated that permitted only backward seeing and compressed brachial plexus between scaleni muscles with sensory, motor and trophic troubles in the hand. A toxic aethiology from parathion is likely. Brainstem Acoustic Evoked Potentials (BAEPs) showed in the beginning abnormal responses, especially as refers to waves originating in the mesencephalon. Therapy with L-5-hydroxytryptophan subdued neurological symptoms; a parallel normalization of BAEPs recording was observed. The Authors propose to call this syndrome (spasmodic torticollis with thoracic outlet syndrome) after the mythical diviner Manto, which Dante Alighieri refers to in his "Divina Commedia" (Inferno, XX, 55 e segg.).
D006916:5-Hydroxytryptophan / Q000627:therapeutic use*; D000328:Adult; D001917:Brachial Plexus; D005260:Female; D006225:Hand; D006801:Humans; D008743:Methyl Parathion / Q000506:poisoning*; D009069:Movement Disorders / Q000209:etiology; D009409:Nerve Crush; D010278:Parathion / Q000031:analogs & derivatives*; D010292:Paresthesia / Q000209:etiology; D014103:Torticollis / Q000209:etiology*
D008743:Methyl Parathion; D010278:Parathion; D006916:5-Hydroxytryptophan
Torcicollo spasmodico configurante sindrome di Manto, a sospetta etiologia tossica, correlato ad alterazioni dei potenziali evocati acustici del tronco cerebrale. Osservazione per oltre un anno. Terapia con L-5-idrossitriptofano. Riduzione d'alto grado della sintomatologia, normalizzazione dei potenziali.