Torticollis: Difference between revisions
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==Background== | ==Background== | ||
*Common term for various conditions of head and neck dystonia | *Common term for various conditions of head and neck dystonia | ||
* | *Spasmodic torticollis is an abnormal contraction of the muscle in one side of the neck. | ||
* | *Cause is generally idiopathic (80-90%) | ||
==Clinical Features== | ==Clinical Features== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Neck pain DDX}} | {{Neck pain DDX}} | ||
*Anterior horn disease | *Anterior horn disease | ||
*C1 and C2 fractures | *C1 and C2 fractures | ||
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==Evaluation== | ==Evaluation== | ||
*Clinical Diagnosis | *Clinical Diagnosis | ||
*Consider cervical X-ray to rule out fracture or dislocation (unlikely to be necessary if no midline tenderness or history of trauma) | |||
==Management== | ==Management== | ||
===Acute=== | ===Acute=== | ||
*Pain control and muscle relaxation (PO [[Benzodiazepine]] or [[Opioid]]) | |||
===Chronic=== | ===Chronic=== | ||
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==Disposition== | ==Disposition== | ||
* | *Discharge | ||
==See Also== | ==See Also== | ||
*[[ | *[[Neck pain]] | ||
==References== | ==References== | ||
<references/> | |||
[[Category:ENT]] | [[Category:ENT]] | ||
Revision as of 17:23, 26 May 2017
Background
- Common term for various conditions of head and neck dystonia
- Spasmodic torticollis is an abnormal contraction of the muscle in one side of the neck.
- Cause is generally idiopathic (80-90%)
Clinical Features
- Painful neck with inability to fully range laterally
Differential Diagnosis
Neck pain
- Musculoskeletal
- Torticollis
- Dystonic reaction
- Cervical spondylosis
- Cervical stenosis
- Cancer
- Epidural abscess
- Vertebral osteomyelitis
- Transverse myelitis
- Temporal arteritis
- Epidural hematoma (anticoagulation, hemophilia)
- Cervical disk herniation
- Blunt neck trauma
- Anterior horn disease
- Cervical fractures and dislocations
- Cervical radiculopathy
- Anterior horn disease
- C1 and C2 fractures
- Radiculopathy
Evaluation
- Clinical Diagnosis
- Consider cervical X-ray to rule out fracture or dislocation (unlikely to be necessary if no midline tenderness or history of trauma)
Management
Acute
- Pain control and muscle relaxation (PO Benzodiazepine or Opioid)
Chronic
- Benztropine
- Muscle relaxants
- Botulinum toxin
- Physical Therapy
Disposition
- Discharge