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:
- Positioning of the infant to avoid sleeping on one side
- Positioning of toys to encourage turning of the head
- Stretching exercises several times each day
- In some situations, surgery to cut the muscle that causes torticollis
- Deep brain stimulation surgery
- Identifying the cause
- Physical therapy to help relax the muscle and reduce pain
- In some situations, surgery to cut the nerve to the muscle that is in spasm
- Anticholinergic drugs, such as trihexyphenidyl (Artane) , benztropine (Cogentin) , and ethopropazine (Parsitan)
- Dopaminergic drugs that increase dopamine levels, such as levodopa (Sinemet or Madopar) or bromocriptine (Parlodel) , or conversely, drugs that decrease dopamine levels such as, clozapine (Clozaril) and tetrabenazine (Nitoman)
- Benzodiazepines that block Gaba-A receptors, such as diazepam (Valium) or clonazepam (Klonopin)
- Injection of botulinum toxin to weaken or partially paralyze the muscle—This may help improve neck posture, but only if begun soon after torticollis begins. The drug's effect wears off after several months and treatment must be repeated.
- Injection of alcohol or phenol to deaden the nerve that causes the muscle contraction
Each of these options has risks and benefits. Work with your doctor to find the right treatment for you.
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