Torticollis is a chronic condition in which a person is unable to control neck muscles from contracting. This causes the head to turn and tilt to one side, and the chin to point to the opposite side. Sometimes one shoulder is lifted. The muscle contraction may be constant (fixed) or may come and go (intermittent). The abnormal posture caused by tilting the head may lead to neck pain.
Torticollis may be present at birth (congenital) or develop later in life (acquired).
The causes are not well understood. Researchers are investigating genetic, environmental, or other causes that may play a role.
Causes may include:
Factors that may increase your chance of developing this condition include:
Muscles of the Neck
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Symptoms may include:
Torticollis ranges from mild to severe. It usually progresses slowly for 1-5 years, and then stays the same. However, torticollis may last for life and can result in limited movement and deformed posture.
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Your doctor may need pictures of structures inside your body. This can be done with:
The treatment for torticollis depends on whether it is congenital or acquired. Treatment generally centers on physical therapy, oral medication, botulinum toxin injections, and surgery. Possible treatments may include:
Each of these options has risks and benefits. Work with your doctor to find the right treatment for you.
RESOURCES:
Dystonia Medical Research Foundation
http://www.dystonia-foundation.org/
National Spasmodic Torticollis Association
http://www.torticollis.org/
Worldwide Education and Awareness for Movement Disorders
http://www.wemove.org/
References:
Cervical dystonia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated August 29, 2012. Accessed January 7, 2013.
Cervical dystonia (spasmodic torticollis). Dystonia Medical Research Foundation website. Available at: http://www.dystonia-foundation.org/pages/cervical_dystonia_more_info/46.php . Accessed January 7, 2013.
Collins A, Jankovic J. Botulinum toxin injection for congenital muscular torticollis presenting in children and adults. Neurology . 2006;67:1083-1085.
Corrado G, Fossati C, Turchetti A, Pacchiarotti C, Nardelli F, D'Eufemia P. Irritable oesophagus: A new cause of Sandifer's syndrome. Acta Paediatr . 2006;95:1509-1510.
Dystonias fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/dystonias/detail_dystonias.htm . Updated November 20, 2012. Accessed January 7, 2013.
Herman MJ. Torticollis in infants and children: common and unusual causes. Instr Course Lect . 2006;55:647-653.
Hoehn KS, Capouya JD, Daum RS, et al. Lemierre-like syndrome caused by community-associated methicillin-resistant Staphylococcus aureus complicated by hemorrhagic pericarditis. Pediatr Crit Care Med . 2010;11(3):e32-5.
Preto TE, Dalvi A, Kang UJ, Penn RD. A prospective blinded evaluation of deep brain stimulation for the treatment of secondary dystonia and primary torticollis syndromes. J Neurosurg. 2008;109:405-409.
Last reviewed November 2012 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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