- Wry neck
- Congenital torticollis
- Idiopathic torticollis
- 723.5 Torticollis unspecified
- Torticollis is a postural position of the neck with side-bending
and opposite rotation
- Contracted state of the cervical muscles
- Cervical 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
cervical dystonia often present with combined postures associated
with flexion, extension and side-bending.
- Moving from side to side is called rotational spasmodic torticollis
- Turning and shaking of the head is called mixed torticollis
- Inherited: change in chromosomes
- Acquired: damage to muscle or nerve
- Idiopathic: unknown cause
- Congenital: in fetal development, improper position of the
fetus with changes in the blood supply or muscles of the neck
- Age of onset
- Distribution of symptoms
- Can have an etiology or can be idiopathic
- Treatment can include stretching, manual therapy, Botox injections
- Musculoskeletal condition during infancy is called congenital
- Enlargement of the neck muscles
- Limited ROM of neck
- Swelling of neck muscles at birth with congenital
- Shoulder elevation on affected side
- Ipsilateral head tilt and contralateral head rotation
- Possible difficulty swallowing2
- Marked limitation in ROM
- Postural control abnormalities
- Greater reliance on vision for maintaining postural stability3
- Reduced ability to perform ADLs involving head or neck movements
- Difficulty sleeping
- Reduced psychosocial functioning
- Idiopathic cause
- Posture during sleeping
- Posture of fetus in womb
- Cold breeze on the neck
- Diagnosis is by clinical examination; no standard laboratory
tests are employed to diagnose.
- Determining that there is no evidence of dystonia
- In addition to the possible contributing causes listed above,
the following pathologies must be ruled out to diagnose primary
- Electromyography (EMG)
- Rule out congenital deformities of the cervical spine, ocular
anomalies, CNS pathology,5 neoplasm, thyroiditis, endocrine
- Diagnosis is made by clinical observation
- Toronto western spasmodic torticollis rating scale
- Torticollis rating scale of Tsui
- Cervical dystonia impact profile
- Botulinum toxin A
- Two preparations are available: Botox and
- Injected into overactive musculature to weaken dystonic muscles
- Injections often performed with electromyography (EMG) to
- Average duration ...
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