Torticollis is a descriptive term for when the chin is irresistibly twisted upwards and towards one side. This condition may be congenital - infantile torticollis - or secondary.
Possible causes of secondary torticollis include:
- an acute disc prolapse - the most common cause in adults
- inflammation of the neck glands
- infection of the vertebrae
- cervical spine injury
- ocular disorders
Torticollis can also occur in adults for various reasons, such as following a neck injury or simply sleeping in an awkward position
- a patient may find that upon awakening it is extremely difficult to lift one's head or is extremely painful to move it
- may be secondary to a vertebral facet joint pinching its capsule resulting in soft tissue inflammation and muscle spasm around it
Management of adult with torticollis in primary care:
- analgesia
- NSAIDs
- muscle relaxants such as diazepam may be used if severe muscle spasm
- gentle manipulation of the neck may be helpful
- taking the weight of the head and applying a little upward traction while gently and slowly rotating the head to each side in the horizontal plane
- generally produces an increase in range of movement, reduction in pain and straightening of the posture - may be temporary
- generally symptoms improve within a few weeks
Notes:
- spasmodic torticollis (cervical dystonia) is a chronic neurological condition that is a clinically distinct form of torticollis