Acquired torticollis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Acquired torticollis (cervical dystonia) is a rare, typically idiopathic, brain disorder causing involuntary neck movements.
Often associated with pain.
Patients may be able to relieve their symptoms by touching their neck, head, or face in a certain way (sensory trick).
Targeted intramuscular injection of botulinum toxin is the therapy with the best proven efficacy. Oral medications and physical therapy may also have a role in the treatment of the condition.
Treatment options for refractory acquired torticollis include deep brain stimulation, radiofrequency ablation, selective surgical denervation, chemical denervation, and intrathecal baclofen.

Patient with moderate left torticollis or neck rotation, mild right laterocollis or lateral neck flexion, and mild retrocollis or neck extension

From the collection of Dr David Sommer

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Patient with moderate left torticollis or neck rotation, mild right laterocollis or lateral neck flexion, and mild retrocollis or neck extension
Patient with severe left torticollis (note hypertrophy of right sternocleidomastoid muscle)
Patient using sensory trick with reduction in dystonia severity

Citations

Key Articles

Stacy M. Epidemiology, clinical presentation, and diagnosis of cervical dystonia. Neurol Clin. 2008 May;26(suppl 1):23-42.[Abstract]
Singer C, Velickovic M. Cervical dystonia: etiology and pathophysiology. Neurol Clin. 2008 May;26(suppl 1):9-22.[Abstract]
Colosimo C, Suppa A, Fabbrini G, et al. Craniocervical dystonia: clinical and pathophysiological features. Eur J Neurol. 2010 Jul;17(suppl 1):15-21.[Abstract]
Rodrigues FB, Duarte GS, Marques RE, et al. Botulinum toxin type A therapy for cervical dystonia. Cochrane Database Syst Rev. 2020 Nov 12;11:CD003633.[Abstract][Full Text]
Dashtipour K, Lew M. Cervical dystonia. In: Stacy MA, ed. Handbook of dystonia. New York, NY: Informa Healthcare; 2007:137-53.
Jankovic J, Leder S, Warner D, et al. Cervical dystonia: clinical findings and associated movement disorders. Neurology. 1991 Jul;41(7):1088-91.[Abstract]

Referenced Articles

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54. Lew MF, Brashear A, Factor S. The safety and efficacy of botulinum toxin type B in the treatment of patients with cervical dystonia: summary of three controlled clinical trials. Neurology. 2000;55(12 suppl 5):S29-35.[Abstract]
55. Dashtipour K, Lew M. Cervical dystonia. In: Stacy MA, ed. Handbook of dystonia. New York, NY: Informa Healthcare; 2007:137-53.
56. Jahanshahi M, Marion MH, Marsden CD. Natural history of adult-onset idiopathic torticollis. Arch Neurol. 1990 May;47(5):548-52.[Abstract]
57. Camfield L, Ben-Shlomo Y, Warner TT. Impact of cervical dystonia on quality of life. Mov Disord. 2002 Jul;17(4):838-41.[Abstract]
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