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: Genetic defectInfant's position during pregnancy or deliveryHead or neck injuryInfection in neck muscles or bonesDamage or failure of the nervous systemInner ear or eye problemsDeformities of the bones or muscles in the neckTumors of the head
of the neck
Use of certain medications
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: Rotation and tilting of the head to one sideShortening of neck muscles on one side, possibly present at birthStiffness of neck musclesPainful spasms of neck and upper back musclesLimited range of motion of the head and neckHeadache
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.
Pictures may be needed of your bodily structures. This can be done with: X-raysCT scanMRI scan
The treatment for torticollis depends on whether it is
or acquired. Treatment generally centers on physical therapy, oral medication, botulinum toxin injections, and surgery. Possible treatments may include:
Stretching exercises several times each dayIn some situations, surgery to lengthen the tendon
Identifying the causePhysical therapy, especially when used with botulinum toxin, to help relax the muscle and reduce painIn some situations, surgery to cut the nerve to the muscle that is in spasmDeep brain stimulation surgeryCertain oral medications, such as pain medication and muscle relaxants
of: Botulinum toxin
to weaken or partially paralyze the muscle—This may help improve neck posture, but only if begun soon after torticollis begins. The drug's effect wears off after several months and treatment must be repeated.Alcohol or phenol to deaden the nerve that causes the muscle contraction
There are no guidelines to prevent torticollis. Early treatment may help keep the symptoms from worsening.
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 16, 2015.
Cervical dystonia. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated October 23, 2014. Accessed June 16, 2015.
Collins A, Jankovic J. Botulinum toxin injection for congenital muscular torticollis presenting in children and adults.
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 23, 2015. Accessed June 16, 2015.
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.
Preto TE, Dalvi A, et al. A prospective blinded evaluation of deep brain stimulation for the treatment of secondary dystonia and primary torticollis syndromes.
Last reviewed June 2015 by Michael Woods, MD
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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