What is torticollis?

Causes and Symptoms

Torticollis occurs equally in the sexes and may develop in childhood or adulthood. Its causes are unknown, but some cases seem to be genetic, while others are acquired from secondary damage to the nerves affecting the head or neck muscles. Congenital torticollis may be caused at birth by malpositioning of the head in the uterus or by prenatal injury of the muscles or blood supply in the neck. Torticollis results from abnormal functioning of the basal ganglia, situated at the base of the brain, which control all coordinated movements.

The first symptoms may appear gradually as the head tends to rotate or turn to one side involuntarily. Other symptoms may involve asymmetry of an infant’s head from sleeping on the affected side, enlargement or stiffness of the neck muscles, limited range of head motion, neck pain, and even headaches.

Treatment and Therapy

Because the cause of torticollis is unknown in most cases, presently no certain cure exists. Drug therapy is frequently employed, but these medications often produce only unpredictable, short-term benefits. Some patients experience relief when treated by physiotherapists, who may use local moist heat, ice, ultrasonography, or a custom-fitted soft collar. Surgery is not recommended as an initial treatment, but it has proven helpful in cases unresponsive to medication.

Perspective and Prospects

Torticollis is easiest to correct in infants and children and in adults who receive early treatment. With chronic conditions, tingling and numbness may develop as nerve roots in the cervical spine become depressed. Recent innovative surgical procedures are helpful, but they are not a complete cure for chronic spasmodic torticollis. Patients with long-term torticollis will probably retain some degree of head tilt or rotation.

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