Torticollis: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
* | *[[Neck pain]] with inability to fully range laterally | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Neck pain DDX}} | {{Neck pain DDX}} | ||
*Anterior horn disease | *Anterior horn disease | ||
*C1 and C2 fractures | *[[cervical spine fractures and dislocations|C1 and C2 fractures]] | ||
*Radiculopathy | *Radiculopathy | ||
| Line 19: | Line 19: | ||
==Management== | ==Management== | ||
===Acute=== | ===Acute=== | ||
*Pain control and muscle relaxation (PO [[ | *Pain control and muscle relaxation (PO [[benzodiazepine]] or [[opioid]]) | ||
===Chronic=== | ===Chronic=== | ||
Revision as of 18:51, 28 September 2019
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
- Neck pain 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