Skip to Main Content

++

  • Focal dystonia
  • Dystonia
  • Spasmodic torticollis
  • Anterocollis
  • Retrocollois
  • Laterocollis

++

  • 333.83 Spasmodic torticollis

++

  • G24.3 Spasmodic torticollis

++
++

Description

++

  • Dystonia is a condition that is characterized by involuntary intermittent or prolonged muscular contractions, such as twisting or repetitive movements, which may cause abnormal postures and movements
  • Dystonia may be generalized or focal
  • Cervical dystonia (CD) is the most common focal dystonia
  • Cervical dystonia 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 upon head position or movement2

++

Essentials of Diagnosis

++

  • Traditional classification is based upon etiology
    • Primary (idiopathic)
    • Secondary (of known cause)
  • Current classification describes each person based upon the following characteristics
    • Age of onset
    • Distribution of symptoms

++

General Considerations

++

++

Demographics

++

++

Signs and Symptoms

++

  • Common to patients with primary and secondary CD
    • Pain
    • Enlargement of the neck muscles
    • Shoulder elevation on affected side
    • Ipsilateral head tilt and contralateral head rotation
    • Head tremor or spasmotic jerking
    • Tremors of the arm
    • Possible difficulty swallowing
  • Unique to patients with post-traumatic CD
    • Marked limitation in range of motion
    • Lack of improvement after sleep
    • Lack of Geste antagoniste, also known as sensory tricks, are physical positioning, such as touching the chin, which have been shown to temporarily reduce dystonia5

++

Functional Implications

++

  • Postural control abnormalities
  • Greater reliance on vision for maintaining postural stability1
  • Reduced ability to perform activities of daily living involving head or neck movements
  • Difficulty sleeping
  • Reduced psychosocial functioning

++

Possible Contributing Causes

++

  • Primary cervical dystonia
    • Idiopathic cause
  • Secondary cervical dystonia
    • Drugs
      • Neuroleptics
      • Dopamine agonists
      • Anticonvulsants
      • Antimalarial drugs
    • Environmental toxins
      • Manganese
      • Carbon monoxide
      • Methanol
    • CNS lesions
      • Intramedullary lesions of the cervical cord
      • Focal brain lesions, such as vascular malformation, tumor, ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

Create a Free MyAccess Profile

* Required Fields

Note: If you have registered for a MyAccess profile on any of the Access sites, you can use the same MyAccess login credentials across all sites.

Passwords must be between 6 and 40 characters long (no whitespace), cannot contain characters #, &, and must contain:
  • at least one lowercase letter
  • at least one uppercase letter
  • at least one digit

Benefits of a MyAccess Profile:

  • Remote access to the site off-campus on any device
  • Notification of new content via custom alerts
  • Bookmark your favorite content such as chapters, figures, tables, videos, cases and more
  • Save and download images to PowerPoint
  • Self-Assessment quizzes saved for quick review
  • Custom Curriculum access for both instructors and learners

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.