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CONDITION/DISORDER SYNONYMS

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  • Acquired torticollis

  • Adult torticollis

  • Anterocollis

  • Dystonia

  • Focal dystonia

  • Laterocollis

  • Retrocollis

  • Spasmodic torticollis

  • Torticollis

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ICD-9-CM CODES

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  • 333.83 Spasmodic torticollis

  • 723.5 Torticollis unspecified

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ICD-10-CM CODES

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  • G24.3 Spasmodic torticollis

  • M43.6 Torticollis

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PREFERRED PRACTICE PATTERN

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  • 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation

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PATIENT PRESENTATION

Patient is a 66-year-old woman who has complaints over the last 2 years of neck pain and a pulling to the right side. Over the last year, she has had head tremors. She has tried Botox injections, which gave her temporary relief. Her friend gave her a cervical collar to wear and feels that if she does not wear it her head falls to the side. Past medical history: Severe whiplash injury 3 years ago due to a car accident.

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KEY FEATURES

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Description
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  • Dystonia is a condition characterized by involuntary intermittent or prolonged muscular contractions (e.g., twisting, jerky, or repetitive movements) that may cause abnormal postures and movements.

  • Dystonia may be generalized or focal.

  • Cervical dystonia (CD) is the most common focal dystonia.

  • CD is commonly referred to as spasmodic torticollis, which may be misleading.

    • Spasmodic describes movements that are intermittent or clonic and tremulous, though some patients with CD present with prolonged contractions.

    • Torticollis implies rotary impairment, though patients with CD often present with combined postures associated with flexion, extension, and side-bending.

  • Further classification may be based on the head position or movement.1

    • Forward tilt is called anterocollis.

    • Backward tilt is called retrocollis.

    • Left or right tilt is called laterocollis.

    • Moving from side to side is called rotational spasmodic torticollis.

    • Turning and shaking of the head is called mixed torticollis.

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FIGURE 120-1

Fascial planes of the neck. (cross-section at C7). (From Lalwani AK. Current Diagnosis & Treatment in Otolaryngology—Head & Neck Surgery. 3rd ed. www.accesssurgery.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
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FIGURE 120-2

(A) Muscles of the neck. (B) Anterior view of the scalene and prevertebral muscles. (From Morton DA, Foreman KB, Albertine KH. The Big Picture: Gross Anatomy. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
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FIGURE 120-3

(A) The principal arteries of the head and neck. (B) The principal venous drainage of the head and neck. (From Morton DA, Foreman KB, Albertine KH. The Big Picture: Gross Anatomy. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
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Essentials of Diagnosis
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  • Traditional classification is ...

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