(Spasmodic Torticollis; Cervical Dystonia)
by Diane Savitsky, MS
Torticollis is a problem where the head turns and tilts to one side and the chin points to the other side. One shoulder may lift. It may be all the time or may come and go.
The causes aren’t clear. It may be from:
Risk Factors TOP
This problem is more common in females, kids under 10, and adults who are 30-60 years old. You are at risk if someone in your family has this condition.
Symptoms range from mild to severe. It often worsens slowly for 1-5 years. Then it slows and stays the same. It may last for life. It can result in problems moving and affect your posture.
You will be asked about your symptoms and health history. A physical exam will be done.
Pictures may be needed. This can be done with:
Treatment depends on whether the problem has been since birth (congenital) or started later (acquired). Physical therapy, oral medicine, botulinum toxin (Botox) injections, and surgery may be done. Other methods are:
It can’t be prevented. Early medical care may keep things from getting worse.
Dystonia Medical Research Foundation
National Spasmodic Torticollis Association
The College of Family Physicians of Canada
Cervical dystonia. Dystonia Medical Research Foundation website. Available at: https://www.dystonia-foundation.org/what-is-dystonia/forms-of-dystonia/focal-dystonias/cervical-dystonia. Accessed June 4, 2018.
Cervical dystonia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T132176/Cervical-dystonia. Updated April 13, 2017. Accessed June 4, 2018.
Collins A, Jankovic J. Botulinum toxin injection for congenital muscular torticollis presenting in children and adults. Neurology. 2006;67:1083-1085.
Corrado G, Fossati C, et al. Irritable oesophagus: A new cause of Sandifer's syndrome. Acta Paediatr. 2006;95:1509-1510.
Dystonias fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Dystonias-Fact-Sheet. Updated December 7, 2017. Accessed June 4, 2018.
Herman MJ. Torticollis in infants and children: common and unusual causes. Instr Course Lect. 2006;55:647-653.
Hoehn KS, Capouya JD, et al. Lemierre-like syndrome caused by community-associated methicillin-resistant Staphylococcus aureus complicated by hemorrhagic pericarditis. Pediatr Crit Care Med. 2010;11(3):e32-5.
Marion MH, Humberstone M, Grunewald R, Wimalaratna S. British Neurotoxin Network recommendations for managing cervical dystonia in patients with a poor response to Botulinum toxin. Pract Neurol. 2016;0:1-8. Available at:
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Accessed June 4, 2018.
Preto TE, Dalvi A, et al. A prospective blinded evaluation of deep brain stimulation for the treatment of secondary dystonia and primary torticollis syndromes. J Neurosurg. 2008;109:405-409.
Last reviewed June 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 6/16/2015
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