Difference between revisions of "Torticollis"

(Created page with "==Background== *Common term for various conditions of head and neck dystonia *spasmodic torticollis is an abnormal contraction of the muscle in one side of the neck. ==Clinic...")
 
(Differential Diagnosis)
 
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==Background==
 
==Background==
 
*Common term for various conditions of head and neck dystonia
 
*Common term for various conditions of head and neck dystonia
*spasmodic torticollis is an abnormal contraction of the muscle in one side of the neck.
+
*Spasmodic torticollis is an abnormal contraction of the muscle in one side of the neck.
 +
*Cause is generally idiopathic (80-90%)
  
==Clinical Presentation==
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==Clinical Features==
*Idiopathic (80-90%)
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*[[Neck pain]] with inability to fully range laterally
  
==Diagnosis==
+
==Differential Diagnosis==
 +
{{Neck pain DDX}}
 +
{{Jaw spasms DDX}}
 +
{{Movement disorder DDX}}
 +
 
 +
==Evaluation==
 
*Clinical Diagnosis
 
*Clinical Diagnosis
*Neck X-ray to rule out fracture or dislocation
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*Consider cervical X-ray to rule out fracture or dislocation (unlikely to be necessary if no midline tenderness or history of trauma)
  
==Differential Diagnosis==
+
==Management==
*Anterior horn disease
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===Acute===
*C1 and C2 fractures
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*[[analgesia|Pain control]] and muscle relaxation (PO [[benzodiazepine]] or [[opioid]])
*Radiculopathy
 
  
==Treatment==
+
===Chronic===
*Benztropine
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*[[Benztropine]]
 
*Muscle relaxants  
 
*Muscle relaxants  
 
*Botulinum toxin
 
*Botulinum toxin
 
*Physical Therapy
 
*Physical Therapy
+
 
 
==Disposition==
 
==Disposition==
 +
*Discharge
  
 
==See Also==
 
==See Also==
#[[Retropharyngeal abscess]]
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*[[Neck pain]]
 
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*[[Dystonic reaction]]
==Source==
 
*UptoDate
 
*Medscape
 
*www.emedicinehealth.com
 
  
 +
==References==
 +
<references/>
  
[[Category:ID]]
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[[Category:ENT]]

Latest revision as of 13:47, 14 November 2020

Background

  • Common term for various conditions of head and neck dystonia
  • Spasmodic torticollis is an abnormal contraction of the muscle in one side of the neck.
  • Cause is generally idiopathic (80-90%)

Clinical Features

  • Neck pain with inability to fully range laterally

Differential Diagnosis

Neck pain

Jaw Spasms

Movement Disorders and Other Abnormal Contractions

Evaluation

  • Clinical Diagnosis
  • Consider cervical X-ray to rule out fracture or dislocation (unlikely to be necessary if no midline tenderness or history of trauma)

Management

Acute

Chronic

  • Benztropine
  • Muscle relaxants
  • Botulinum toxin
  • Physical Therapy

Disposition

  • Discharge

See Also

References