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Torticollis

Alternate Names

  • spasmodic torticollis
  • congenital torticollis
  • wry neck

Definition

Torticollis is a deformity of the neck in which the muscles are spastic or shortened. Torticollis occurs in 1 out of 10,000 people. It is more common in women than men.

What is going on in the body?

Torticollis develops most often between the ages of 30 and 60. However, it can occur at any age. The deformity causes a person's head to bend toward the affected side. The chin is rotated toward the opposite side.

Risks

What are the causes and risks of the condition?

In some cases torticollis is congenital, meaning that the person is born with the condition.
The condition can also be acquired. This form falls into 3 categories:
  • acute. This is the result of muscle damage caused by inflammatory diseases, such as tuberculosis. It can also be brought on by cervical spinal injuries that produce scar tissue.
  • spasmodic. This is a result of muscle spasms cause by a central nervous disorder.
  • hysterical. This is due to the inability to control one's neck muscles, for some reason that is ultimately psychological

Prevention

What can be done to prevent the condition?

There is no known prevention for this condition.

Diagnosed

How is the condition diagnosed?

A physical exam will show a shortening of the neck muscles and the head tilting toward the affected side. X-rays of the neck may show an associated disorder such as tuberculosis, scar tissue, or arthritis.

Long Term Effects

What are the long-term effects of the condition?

If the condition becomes chronic, numbness and tingling sensations in the arm and hand may develop. This is caused by the nerve roots becoming compressed in the cervical spine.

Other Risks

What are the risks to others?

There are no risks to others.

Treatments

What are the treatments for the condition?

The goal of treatment is to stretch the shortened neck muscle. If an individual is born with the condition, intensive physical therapy is started within the first few months of life. If physical therapy is unsuccessful, the muscle may have to be repaired surgically.
The pain caused by the acquired form of the condition may be eased by the application of heat and gentle massage. Stretching exercises and a neck brace may help to relieve symptoms of the spasmodic and hysterical forms.
Medication such as anticholinergics, which block specific nerve impulses, or mild sedatives may be used. Muscle relaxants and antidepressants are occasionally prescribed. Surgically removing the nerves to the affected neck muscle is sometimes successful. This may be tried if other treatments fail. If emotional problems contribute to the spasms, psychotherapy may help.

Side Effects

What are the side effects of the treatments?

Any surgery can be complicated by bleeding, infection, or an allergic reactions to the anesthetic. Each medication has a different array of possible side effects. Dry mouth, drowsiness, constipation, nausea, and stomach upset are some of the most common.

After Treatment

What happens after treatment for the condition?

Torticollis varies from mild to severe. Some people get full relief after treatment. However, the condition may persist for life. It may produce continued pain, restricted movement of the neck, and postural deformities.

Monitor

How is the condition monitored?

The person can monitor symptoms and contact the healthcare professional as needed.

Sources

Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998

Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000

The Merck Manual of Medical Information, Home edition, 1997

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