Torticollis: Difference between revisions
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==Treatment== | ==Treatment== | ||
===Acute== | |||
''Pain control and muscle relaxation'' | |||
*[[Opioid]] (e.g. 1-2 tabs of [[Norco]]) +/- [[benzodiazepine]] (e.g. [[Ativan]]) PO | |||
===Chronic=== | |||
*Benztropine | *Benztropine | ||
*Muscle relaxants | *Muscle relaxants | ||
*Botulinum toxin | *Botulinum toxin | ||
*Physical Therapy | *Physical Therapy | ||
==Disposition== | ==Disposition== | ||
*Normally outpatient | *Normally outpatient |
Revision as of 17:11, 25 September 2015
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.
- Idiopathic (80-90%)
Clinical Features
- Painful neck with inability to fully range laterally
Differential Diagnosis
Neck pain
- Musculoskeletal
- Torticollis
- Dystonic reaction
- Cervical spondylosis
- Cervical stenosis
- Cancer
- Epidural abscess
- Vertebral osteomyelitis
- Transverse myelitis
- Temporal arteritis
- Epidural hematoma (anticoagulation, hemophilia)
- Cervical disk herniation
- Blunt neck trauma
- Anterior horn disease
- Cervical fractures and dislocations
- Cervical radiculopathy
- Anterior horn disease
- C1 and C2 fractures
- Radiculopathy
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)
Treatment
=Acute
Pain control and muscle relaxation
- Opioid (e.g. 1-2 tabs of Norco) +/- benzodiazepine (e.g. Ativan) PO
Chronic
- Benztropine
- Muscle relaxants
- Botulinum toxin
- Physical Therapy
Disposition
- Normally outpatient
See Also
Source
- UptoDate
- Medscape
- www.emedicinehealth.com