Table of Contents
Introduction
Torticollis is also called as Wryneck
the lateral curvature is usually accompanied by some rotational deformity. nature has defined four physiological curves in co-called erect spine
common features of this include
- rotated face to the other side
- macular changes
- neck tilted to the same side
- taut sternocleidomastoid
- unilateral muscle paralysis
Some congenital disorders or any traumatic sprain can cause it.
spasmodic torticollis is the most common cause of wryneck.
Involuntary twisting or clonic movements of the neck characterize this, the most common form of focal dystonia
Emotional disturbance or attempts at correction sometimes trigger spasms.
Even at rest, the neck typically exhibits an abnormal posture, with the chin twisted to one side and upwards, and the shoulder on that side potentially elevated.
In some cases, the condition reveals as a more generalized form of dystonia when involuntary muscle contractions spread to other areas.
there are the cases associate with lesions of the basal ganglia, but the exact cause remains unknown.”
Some patients respond to local injections of botulinum toxin into the sternomastoid muscle
some acquired causes are
- infective = tuberculosis of cervical spine, acute respiratory tract infection etc,
- ocular disturbance = child turns head to one side to compensate for defective vision
- myositis or fibromyositis of sternocleidomastoid = exposure to cold may cause myositis
- neuritis of spinal accessory nerve
- unilateral muscle paralysis due to polio
clinical features of torticollis
the head of the patient is tilted towards the affected side
while, the chin of the individual points to the other side
sternocleidomastoid muscle is more prominently seen.
perhaps pain and immobility being the most common feature
In the later stages, the patient may develop facial asymmetry and macular disturbance in eyes
Management of torticollis
Initially, doctors manage it with conservative management.
this consists of non steroidal anti-inflammatory drugs (NSAID), muscle relaxants drugs, etc
suggesion of physiotherapy like ultrasound, heat therapy
in the acute condition the individual is asked to wear a collar and gradual neck exercises are advised
safter the failure of conservative management surgery is the step
it consists of release of sternomastoid muscle from its clavicular attachment
as in congenital torticollis and intradural section of both spinal accessory and three cervical roots in case of torticollis due to spasmodic or neural causes
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