Surgical possibilities for alleviation of axial dyskinesias - comparison with forced movements of the head and eyes.

107 patients suffering from axial dyskinesias (torticollis and torsion dystonia) were observed at our clinic over a period of 10 years. In 15 patients, stereotactic lesions involving the head-turning bundle at the caudatocapsular level, which mediates forced adversive movements, were performed. In 70% good to excellent results were confirmed. However, differences between forced adversive movements and torticollis were identified. There are striking motor and motivational similarities between torticollis and ritualized fixed action patterns of low-ranking subjects. The aetiology of axial dyskinesias, especially of torticollis, is multifactorial, long-term psychic stress being an important factor. The relationship of axial dyskinesias, especially of torticollis, to compulsive neuroses is discussed, and Mazar's 'adversive' target area is identified as a partial orbitomedial leukotomy.