Torticollis

Involuntary contraction of neck leading to abnormal posture and movement of head is called Torticollis. It is not a diagnosis but a sign of underlying disorder.

Causes:

1.       Congenital

2.       Acquired

1.      Congenital:

·         Trauma (by birth) to sternocleiodomastoid

·         Spina bifida

·         Vertebral anomalies

·         Clavicle fracture

·         Arnold – chiari malformation (protrusion of lower brain stem and cerebellum through the opening for spinal cord at the base of the skull)

2.      Acquired:

o   Spasm of cervical muscles due to injury to muscles or nerves

o   Awkward position during sleep

o   Cervical spine trauma

o   Retropharyngeal abscess

o   Any infection involving surrounding tissue of neck

o   Drugs: Phenothiazines (piprazine), Metachlopromide

Diagnosis:

§  X – ray of neck

§  MRI/CT of spine

Management:

General:

·         Check airway

·         Patient with trauma stabilize neck

Remember: Cause identification is primary aim and then treatment accordingly.

Specific:

·         Benztropine

·         Benzodiazepine

·         Analgesics

·         Physiotherapy