Torticollis Flashcards
What is torticollis?
= twisted neck
What is the most common congenital cause of torticollis? What is it? Its outcome? Mx?
Congenital muscular torticollis:
○ Unilateral fibrous contracture of SCM
○ Mass is benign and self-limiting (resolves within weeks to months)
○ Manage with physiotherapy (education + stretching), tubular orthosis, surgery
List some acquired causes of torticollis?
Trauma
• Fracture
• Muscle spasm("wry neck")
• Spinal haematoma
• Breech delivery
Infection
• Head and neck: URTI, OM, mastoiditis, cervical adenitis, retropharyngeal abscess
• Spine: osteomyelitis, discitis, epidural abscess
• CNS: meningitis
Inflammation
• Juvenile arthritis
Neoplasm
• CNS tumours
• Bone tumours
Others
• Dystonic syndromes
• Ocular dysfunctione.g. vertical squint
• Atlantoaxial rotary fixation
When should uncomplicated acute torticollis resolve by?
7-10 days
What may you see at the SCM and face with torticollis?
- May see “tumour” of healing before complete scarring takes place in trauma!
- Hemi hypoplasia of the face - asymmetry in growth of facial skeleton as restriction of movement restricts growth (skeleton only grows with movement!)
What are some general mx points for torticollis?
○ Analgesia or anti-inflammatory medications may be effective
○ Heat packs and massage may provide symptomatic relief in cases of wry neck
○ Diazepam can be effective with some cases of spasm of the SCM.
What Rx should dystonic reactions receive?
benztropine
