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(Spasmodic Torticollis; Cervical Dystonia)
by Diane Savitsky, MS
Torticollis affects the ability to control neck muscles from contracting. This causes the head to turn and tilt to one side and the chin to point to the opposite side. Sometimes, one shoulder is lifted. The muscle contraction may be constant or may come and go.
The causes of torticollis are not well understood. Causes may include:
Risk Factors TOP
Torticollis is more common in females, children under 10, and adults aged 30-60 years old.
The only risk factor for torticollis is having a family member with torticollis or a similar disorder.
Symptoms may include:
Torticollis symptoms range from mild to severe. It usually progresses slowly for 1-5 years, and then stays the same. However, torticollis may last for life and can result in limited movement and deformed posture.
You will be asked about your symptoms and medical history. A physical exam will be done.
Images may be needed of your bodily structures. This can be done with:
The treatment for torticollis depends on whether it is congenital or acquired. Treatment generally centers on physical therapy, oral medication, botulinum toxin injections, and surgery. Possible treatments may include:
There are no guidelines to prevent torticollis. Early treatment may help keep the symptoms from worsening.
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 2, 2016.
Cervical dystonia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T132176/Cervical-dystonia. Updated August 23, 2016. Accessed September 14, 2016.
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:
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Updated February 1, 2016. Accessed June 2, 2016.
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:
...(Click grey area to select URL)
Accessed June 2, 2016.
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 2016 by Laura Lei-Rivera, PT, DPT, GCS
Last Updated: 6/16/2015
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