Torticollis affects the ability to control neck muscles from contracting. This causes the head to turn and tilt to one side and the chin to point to the opposite side. Sometimes, one shoulder is lifted. The muscle contraction may be constant or may come and go.
The causes of torticollis are not well understood. Causes may include:
Torticollis is more common in females, children under 10, and adults aged 30-60 years old.
The only risk factor for torticollis is having a family member with torticollis or a similar disorder.
Muscles of the Neck
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Symptoms may include:
Torticollis symptoms range from mild to severe. It usually progresses slowly for 1-5 years, and then stays the same. However, torticollis may last for life and can result in limited movement and deformed posture.
You will be asked about your symptoms and medical history. A physical exam will be done.
Images may be needed of your bodily structures. This can be done with:
The treatment for torticollis depends on whether it is congenital or acquired. Treatment generally centers on physical therapy, oral medication, botulinum toxin injections, and surgery. Possible treatments may include:
Dystonia Medical Research Foundation
National Spasmodic Torticollis Association
The College of Family Physicians of Canada
Cervical dystonia. Dystonia Medical Research Foundation website. Available at: https://www.dystonia-foundation.org/what-is-dystonia/forms-of-dystonia/focal-dystonias/cervical-dystonia. Accessed June 2, 2016.
Cervical dystonia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T132176/Cervical-dystonia. Updated August 23, 2016. Accessed September 14, 2016.
Collins A, Jankovic J. Botulinum toxin injection for congenital muscular torticollis presenting in children and adults. Neurology. 2006;67:1083-1085.
Corrado G, Fossati C, et al. Irritable oesophagus: A new cause of Sandifer's syndrome. Acta Paediatr. 2006;95:1509-1510.
Dystonias fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/dystonias/detail_dystonias.htm. Updated February 1, 2016. Accessed June 2, 2016.
Herman MJ. Torticollis in infants and children: common and unusual causes. Instr Course Lect. 2006;55:647-653.
Hoehn KS, Capouya JD, et al. Lemierre-like syndrome caused by community-associated methicillin-resistant Staphylococcus aureus complicated by hemorrhagic pericarditis. Pediatr Crit Care Med. 2010;11(3):e32-5.
Marion MH, Humberstone M, Grunewald R, Wimalaratna S. British Neurotoxin Network recommendations for managing cervical dystonia in patients with a poor response to Botulinum toxin. Pract Neurol. 2016;0:1-8. Available at: http://pn.bmj.com/content/early/2016/03/14/practneurol-2015-001335.full.pdf+html. Accessed June 2, 2016.
Preto TE, Dalvi A, et al. A prospective blinded evaluation of deep brain stimulation for the treatment of secondary dystonia and primary torticollis syndromes. J Neurosurg. 2008;109:405-409.
Last reviewed June 2016 by Laura Lei-Rivera, PT, DPT, GCS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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