Difference between revisions of "Torticollis"

(Text replacement - "==Treatment==" to "==Management==")
(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.
*Idiopathic (80-90%)
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*Cause is generally idiopathic (80-90%)
  
 
==Clinical Features==
 
==Clinical Features==
*Painful neck with inability to fully range laterally
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*[[Neck pain]] with inability to fully range laterally
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
 
{{Neck pain DDX}}
 
{{Neck pain DDX}}
 +
{{Jaw spasms DDX}}
 +
{{Movement disorder DDX}}
  
*Anterior horn disease
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==Evaluation==
*C1 and C2 fractures
 
*Radiculopathy
 
 
 
==Diagnosis==
 
 
*Clinical Diagnosis
 
*Clinical Diagnosis
**Consider cervical X-ray to rule out fracture or dislocation (unlikely to be necessary if no midline tenderness or history of trauma)
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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)
  
 
==Management==
 
==Management==
 
===Acute===
 
===Acute===
''Pain control and muscle relaxation''
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*[[analgesia|Pain control]] and muscle relaxation (PO [[benzodiazepine]] or [[opioid]])
*[[Opioid]] (e.g. 1-2 tabs of [[Norco]]) +/- [[benzodiazepine]] (e.g. [[diazepam]]) PO
 
  
 
===Chronic===
 
===Chronic===
*Benztropine
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*[[Benztropine]]
 
*Muscle relaxants  
 
*Muscle relaxants  
 
*Botulinum toxin
 
*Botulinum toxin
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==Disposition==
 
==Disposition==
*Normally outpatient
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*Discharge
  
 
==See Also==
 
==See Also==
*[[Retropharyngeal abscess]]
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*[[Neck pain]]
 +
*[[Dystonic reaction]]
  
 
==References==
 
==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