torticollis

Last reviewed 01/2018

Torticollis is a descriptive term for when the chin is irresistibly twisted upwards and towards one side. This condition may be congenital - infantile torticollis - or secondary.

Possible causes of secondary torticollis include:

• an acute disc prolapse - the most common cause in adults
• inflammation of the neck glands
• infection of the vertebrae
• cervical spine injury
• ocular disorders

Torticollis can also occur in adults for various reasons, such as following a neck injury or simply sleeping in an awkward position

• a patient may find that upon awakening it is extremely difficult to lift one's head or is extremely painful to move it
  • may be secondary to a vertebral facet joint pinching its capsule resulting in soft tissue inflammation and muscle spasm around it

Management of adult with torticollis in primary care:

• analgesia
• NSAIDs
• muscle relaxants such as diazepam may be used if severe muscle spasm
• gentle manipulation of the neck may be helpful
  • taking the weight of the head and applying a little upward traction while gently and slowly rotating the head to each side in the horizontal plane
    • generally produces an increase in range of movement, reduction in pain and straightening of the posture - may be temporary
• generally symptoms improve within a few weeks

Notes:

• spasmodic torticollis (cervical dystonia) is a chronic neurological condition that is a clinically distinct form of torticollis