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Acute torticollis



  • Torticollis is a common term for various conditions of head and neck dystonia which displays specific variations in head movement
  • Torticollis results in a fixed or dynamic posturing of the head and neck in tilt, rotation, and flexion
  • Spasms of the sternocleidomastoideus, trapezius and other neck muscles, usually more prominent on one side than the other, cause a turning or tipping of the head.



  • Common between 15-30 years of age
  • Very rare before age of 12 years of age



  • Can result from 12
    • Injury
    • Inflammation of cervical muscles or cranial nerves from different disease process
    • Head/neck trauma
    • Sleeping in an awkward position
    • Post-traumatic (10-20% of cases) – 3 to 12 months after injury – more related to cervical dystonia



  • Patient wakes in the morning experiencing a stiff neck
  • Trying to move the head when getting up is difficult and painful
    • Pain is experienced in neck, trapezius and scapula area
  • More rarely it may develop acutely as a result of specific movements, injury to head or by coughing
  • Moving the neck aggravates the condition
  • The patient finds comfort in lying down, which improves the painful situation
    • If trying to change position while lying down, the patient will often ‘hold the head’ and help in moving the head by using their hands



  • Marked stiffness with severe problems voluntarily making specific neck movements which gives pain when attempted



  • Clear asymmetrical position of the head
    • Usually in lateral flexion of the neck or rotation
    • Head may be deviated towards or away from painful side



  • Neck rotation – painful and severely limited
    • May be in one direction or both
  • Neck lateral flexion – painful and severely limited
    • May be in one direction or both
  • Neck resisted movements of the neck are often painful and weak
  • Shoulder movements can also be limited