Torticollis: Difference between revisions

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==Background==
==Background==
[[File:Sternohyoid muscle.png|thumb|Anterior muscles of the neck.]]
*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.
*Spasmodic torticollis is an abnormal contraction of the muscle in one side of the neck.
*Idiopathic (80-90%)
*Cause is generally idiopathic (80-90%)


==Clinical Features==
==Clinical Features==
*Painful neck with inability to fully range laterally
*[[Neck pain]] with inability to fully range laterally


==Differential Diagnosis==
==Differential Diagnosis==
{{Neck pain DDX}}
{{Neck pain DDX}}
 
{{Jaw spasms DDX}}
*Anterior horn disease
{{Movement disorder DDX}}
*C1 and C2 fractures
*Radiculopathy


==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)
*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''
*[[analgesia|Pain control]] and muscle relaxation (PO [[benzodiazepine]] or [[opioid]])
*[[Opioid]] (e.g. 1-2 tabs of [[Norco]]) +/- [[benzodiazepine]] (e.g. [[diazepam]]) PO


===Chronic===
===Chronic===
*Benztropine
*[[Benztropine]]
*Muscle relaxants  
*Muscle relaxants  
*Botulinum toxin
*Botulinum toxin
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==Disposition==
==Disposition==
*Normally outpatient
*Discharge


==See Also==
==See Also==
*[[Retropharyngeal abscess]]
*[[Neck pain]]
*[[Dystonic reaction]]


==References==
==References==
<references/>


[[Category:ID]]
[[Category:ENT]]

Latest revision as of 14:49, 11 December 2021

Background

Anterior muscles of the neck.
  • 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

Jaw Spasms

Movement Disorders and Other Abnormal Contractions

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

Chronic

  • Benztropine
  • Muscle relaxants
  • Botulinum toxin
  • Physical Therapy

Disposition

  • Discharge

See Also

References