Torticollis

What is Torticollis?

Torticollis or wry neck is a condition characterized by a painfully twisted and tilted neck. The condition is common in children but also occurs in adults. It can be congenital (present at birth) or acquired as a result of damage to the neck muscles or blood supply.

Types of Torticollis

The different types of torticollis include:

• Temporary Torticollis: This type of wry neck normally disappears after one or two days. It can be due to infection, injury, or swollen lymph nodes.
• Fixed Torticollis: Also known as acute torticollis or permanent torticollis, this is usually caused by a muscle or bone structure issue.
• Muscular Torticollis: This is the most common type of torticollis and is caused by scarring or stiff muscles on one side of the neck.
• Klippel-Feil Syndrome: This is a rare congenital form of the wry neck that occurs when the bones in your baby's neck develop improperly - usually due to the fusion of two cervical vertebrae.
• Cervical Dystonia: Another rare type, this is also known as spasmodic torticollis. It causes the neck muscles to contract in spasms, causing violent twisting and turning of the head.

Causes of Torticollis

Some of the causes of torticollis include:

• Gene mutations passed down through families.
• Problems in the nervous system, upper spine, or muscles
• Incorrect positioning of your baby's head.
• Damage to the muscles or blood supply to the neck

Symptoms of Torticollis

Signs and symptoms of torticollis include:

• Limited movement of the head
• Headache
• Neck pain
• One shoulder is higher than the other
• Stiffness or swelling of the neck muscles
• Tilting of your chin to one side

Diagnosis of Torticollis

Your doctor will review your medical history and symptoms and conduct an examination of your neck and head. In the physical examination, range of motion of the head and neck will be evaluated, looking for any asymmetry or unevenness of the face and head. Your doctor may also order the following diagnostic tests:

• X-rays: During this study, high-energy electromagnetic beams are used to produce images of the bones and internal structures.
• CT scan: During this study, special x-rays are used to produce detailed images of the cervical spine and surrounding tissues.
• MRI Scan: This is an imaging study that uses a large magnetic field and radio waves to detect any damage to the soft tissues.
• Electromyogram (EMG): This is a test to monitor the electrical activity in your muscles. It can help isolate torticollis to specific neck muscles.

Treatment of Torticollis

Treatments for torticollis include:

• Medications: Your doctor may prescribe non-steroidal anti-inflammatory medications to relieve neck pain and inflammation. Antibiotic treatment may be prescribed for infection-related torticollis.
• Physical Therapy: Strengthening and stretching exercises can help to improve range of motion and fortify the muscles.
• Applying heat, traction, and massage to the neck can help relieve head and neck pain.
• Muscle spasms can be relieved by stretching exercises and neck supports.
• Deep brain stimulation is an option for treating spasmodic torticollis (cervical dystonia).
• When torticollis is caused by displaced vertebrae, spine surgery may be required to restore proper alignment and decompress nerves in the neck.