MedlinePlus Medical Encyclopedia: Torticollis

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Torticollis

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Torticollis (wry neck)

Alternative names Return to top

Wry neck; Loxia

Definition Return to top

Torticollis is prolonged contraction of the neck muscles that causes the head to turn to one side.

Causes, incidence, and risk factors Return to top

Torticollis may occur without known cause (idiopathic), be genetic (inherited), or be acquired secondary to damage to the nervous system or muscles. It may develop in childhood or adulthood. Congenital torticollis (present at birth) may be caused by malpositioning of the head in the uterus, or by prenatal injury of the muscles or blood supply in the neck.

Symptoms Return to top

Enlargement of the neck muscles (possibly present at birth)
Asymmetry of an infant's head from sleeping on the affected side
Elevation of the shoulder on the affected side
Stiffness of neck muscles
Limited range of motion
Headache
Neck pain
Head tremor

Signs and tests Return to top

Various tests or procedures may be done to rule out possible causes of head and neck pain. A physical examination will show a visible shortening of the neck muscles and the head will tilt toward the affected side while the chin points to the opposite side.

Treatment Return to top

Treatment of congenital torticollis involves stretching the shortened neck muscle. Passive stretching and positioning are treatments used in infants and small children. Surgical sectioning of the neck muscle may be done in the preschool years, if other treatment methods fail.

Acquired torticollis is treated by identifying the underlying cause of the disorder. Application of heat, traction to the cervical spine, and massage may help relieve head and neck pain. Stretching exercises and neck braces may help with muscle spasms.

Drug treatments include anticholinergic drugs (baclofen). Injection of botulinum toxin is very effective to temporarily relieve the torticollis, but repeat injections every three months are usually required. Surgical treatments are rarely used.

Expectations (prognosis) Return to top

The condition may be easier to correct in infants and children. If the condition becomes chronic, numbness and tingling may develop as nerve roots become compressed in the neck. Botulinum toxin injections often provide substantial relief.

Complications Return to top

Some complications include neurological symptoms from compressed nerve roots.

Calling your health care provider Return to top

Call for an appointment with your health care provider if symptoms do not improve with treatment, or if new symptoms develop.

Prevention Return to top

While there is no known prevention, early treatment may prevent a worsening of the condition.

Update Date: 1/16/2004

Updated by: Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Newton, Ma., and Senior Medical Editor, A.D.A.M., Inc. Previously reviewed by Elaine T. Kiriakopoulos, M.D., M.Sc., Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network (5/8/2003).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.