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Torticollis – Pictures, Causes, Symptoms, Treatment

Torticollis is a painful condition identified by uncontrolled contraction of the muscles in the neck, thus causing the head to twist or turn in a particular direction. Torticollis may also lead to involuntary tilting of the head towards the front or back.

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Torticollis is an uncommon disorder that occurs across age groups. However, spasmodic torticollis is more common in women as opposed to men. Additionally, it mostly tends to affect middle aged adults. The symptoms of torticollis generally tend to develop slowly till they reach a point where the signs do not experience any progress in the levels of severity.

There is no known cure for torticollis. On occasions, the disorder may cure on its own without medical treatment, with uncommon instances of remission. The symptoms associated with torticollis may be reduced with botulinum toxin injections given to the affected muscles. Surgical correction of the condition is an option that is rarely exercised.

Types of torticollis

Torticollis is divided into 3 types, i.e. congenital muscular torticollis, acquired torticollis and spasmodic torticollis

  • Congenital muscular torticollis can be seen at birth and may result from disturbances during fetal development or from delivery problems. The disorder has to be rectified before the patient become 18 years old to facilitate some kind of improvement
  • Acquired torticollis occurs after the birth and is caused due to several anomalies and problems which were formerly absent in the affected child or adult. It is a self-restraining condition that has a sudden onset and also tends to disappear on its own
  • Spasmodic torticollis is a non-permanent form of torticollis that is prone to relapses. It is also referred to as cervical dystonia

Torticollis Symptoms

The contractions of the muscles that accompany torticollis can cause the head to twist in several different directions such as:

  • Chin twists straight down
  • Chin twists straight up
  • Chin twists towards the shoulder
  • Ear twists towards the shoulder

Pulling of the chin towards the shoulder is the most common type of head twisting associated with torticollis. Some patients may experience a combination of anomalous head postures. A jerky movement of the head can also be noticed

Some children affected by torticollis may also experience the symptoms of the condition in nearby regions such as the shoulder or the face. However, unlike the child patients, there is no migration of torticollis to other larger parts of the body in middle-aged patients

Most patients may experience passage of the neck pain to the shoulders. They may also suffer from headaches. Some affected individuals may become excessively tired and elicit disablement from such severe pain.

The disability and pain occurring in torticollis affected people may ultimately cause the development of depression in them

Causes of torticollis

In most cases, doctors generally do not know the causes of why some individuals are affected by torticollis, while others remain unaffected. Some instances of torticollis have been found to have the below listed probable causes:

  • Intake of certain drugs, particularly specific anti-psychotic or anti-nausea agents
  • Injuries of the head, neck, or shoulders

A few risk factors which can increase the susceptibility to developing torticollis are listed below:

  • Women are two times more vulnerable to torticollis as compared to men
  • Even though torticollis affects people of all ages including infants, it is more common in the age group of 40 and 70 year olds
  • A family history of torticollis or some other form of dystonia can increase the vulnerability to the condition

Treatment of torticollis and exercises

As torticollis has no known cure, treatment is aimed at alleviation and management of symptoms, as discussed below:

  • Medications: A combination of medications may be recommended to decrease the symptoms.
    • Botulinum toxin is a paralyzing agent generally used to even facial wrinkles. It is injected directly into the affected muscles of the neck. Improvement is almost immediate. The treatment needs to be performed every three to 4 months
    • Parkinson’s disease drugs used to treat tremors are also prescribed
    • Muscle relaxants may help, but can cause some side effects
    • The pain can be eased with prescription and non-prescription pain killer drugs
    • Therapy: The symptoms of torticollis can also be alleviated via therapy
      • Specific exercises to augment the flexibility and power or the neck muscles
      • A neck brace may be recommended as per individual cases
      • Stress management techniques are taught to the patients
      • Surgery and other treatment procedures: In case other treatment procedures do not yield satisfactory results, then doctors may opt for surgical intervention
        • Some of the nerves and muscles which play a part in the development of neck contortions may be surgically cut off. This type of surgery is called selective denervation surgery. It is not widely available
        • DBS or deep brain stimulation: It is another surgical treatment procedure for correcting the abnormalities of torticollis. First a hole is made in the skull. Then an insulated, thin wire is inserted into the brain via the hole. The end with the electrode is place in that region of the brain which controls motion. Then using a wire that passes under the skin, it is attached to a battery pack placed in the chest. The battery passes signals to the brain to break off the anomalous nerve signals that result in the characteristic torticollis neck distortions
        • Exercises for babies – When the baby wants to be breast-fed or bottle-fed,  place them in a way that makes the baby turn away from the side it normally latches on to.  Make the baby sleep on his her back.  While playing with your baby, make it distracted with toys and sounds that allow it to turns its head in both directions.

        Torticollis  Pictures

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