Difference between revisions of "Torticollis"

(Diagnosis)
(Treatment)
Line 19: Line 19:
  
 
==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

  • 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

Chronic

  • Benztropine
  • Muscle relaxants
  • Botulinum toxin
  • Physical Therapy

Disposition

  • Normally outpatient

See Also

Source

  • UptoDate
  • Medscape
  • www.emedicinehealth.com