Torticollis is a chronic condition in which the neck muscles contract involuntarily. 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 underlying mechanisms that may play a role.
Causes may include:
These factors increase your chance of developing this condition. Tell your doctor if you have any of these risk factors:
Symptoms may include:
Torticollis ranges from mild to severe. It usually progresses slowly for 1-5 years, and then plateaus. However, torticollis may persist for life and can result in limited movement and deformed posture.
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include:
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/
CANADIAN RESOURCES:
Canadian Family Physician
http://www.cfpc.ca/cfp/
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
References:
Beers MH, Berkow R. The Merck Manual Diagnosis and Therapy . 17th ed. Whitehouse Station, NJ: Merck & Co; 1999.
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.
Herman MJ. Torticollis in infants and children: common and unusual causes. Instr Course Lect . 2006;55:647-653.
National Institute of Child Health and Human Development website. Available at: http://www.nichd.nih.gov/ .
National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/ .
Preto TE, Dalvi A, Kang UJ, Penn RD. A prospective blinded evaluation of deep brain stimulation for the treatment of secondary dystonia nad primary torticollis syndromes. J Neurosurg. 2008;109:405-409.
Last reviewed January 2009 by Rimas Lukas, 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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