(Spasmodic Torticollis; Cervical Dystonia)
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:
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.
There are no guidelines to prevent torticollis. Early treatment may help keep the symptoms from worsening.
Dystonia Medical Research Foundation
National Spasmodic Torticollis Association
Worldwide Education and Awareness for Movement Disorders
Canadian Family Physician
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.dystoni... . Accessed January 7, 2013.
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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