Torticollis

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Background

  • Common term for various conditions of head and neck dystonia
  • spasmodic torticollis is an abnormal contraction of the muscle in one side of the neck.
  • Idiopathic (80-90%)

Clinical Features

  • Painful neck with inability to fully range laterally

Differential Diagnosis

Neck pain

  • Anterior horn disease
  • C1 and C2 fractures
  • Radiculopathy

Evaluation

  • Clinical Diagnosis
    • Consider cervical X-ray to rule out fracture or dislocation (unlikely to be necessary if no midline tenderness or history of trauma)

Management

Acute

Pain control and muscle relaxation

Chronic

  • Benztropine
  • Muscle relaxants
  • Botulinum toxin
  • Physical Therapy

Disposition

  • Normally outpatient

See Also

References