Spasmodic Torticollis
Spasmodic Torticollis generally appears between the ages of Thirty and fifty and is more common in women than men. Involuntary contractions of the sternocleidomastoid muscles of the neck cause the classic rotation of the head toward the affected side with the face being turned in the opposite direction. Spasmodic torticollis is frequently misdiagnosed and can take years to be diagnosed correctly even though it is one of the most common types of focal dystonia. Spasmodic torticollis is often misdiagnosed as Parkinson’s disease, muscular dystrophy, or epilepsy. Approximately 3 in every 10000 people suffer from the disorder which can be both painful and debilitating.
It’s not clearly understood what causes spasmodic torticollis but it is felt certain medications such as the antipsychotics; an infection, tumor, or injury to the neck may be the culprit. It can also be secondary to certain brain lesions. Interestingly, there also seems to be a genetic component to the disease with patients often having family members who have also had the disorder. Stress is felt to be a contributing factor in the disease.
The symptoms of spasmodic torticollis usually develop slowly but can occasionally develop suddenly. The patient may notice difficulty keeping his head straight in activities such as driving. The head may tilt to in a turned positions to the side, be pulled over with the ear pulling towards the shoulder, backwards or toward the front with the patient experiencing difficulty lifting the head. Pain is generally on one side of the neck or in the back and shoulder. Twisting, turning and tremors of the head or a combination of all three may be experienced. Symptoms can be intermittent and range from mild to severe. Patients may have no symptoms upon rising in the morning for a period of several minutes to several hours.
Diagnosis of primary spasmodic torticollis is made based on history, physical exam and ruling out such problems as neck infection, tumors and injury. If infection, tumor or injury to the structures of the neck are the cause of spasmodic torticollis it is considered secondary.
Treatment of spasmodic torticollis involves physical therapy, massage, heat, muscle relaxants, anti-anxiety agents and pain medication. Injections of botulinum toxin into the affected muscle can bring relief of spasms for one to three months. These injections may decrease in effectiveness over time because the body can develop antibodies against the toxin. . Biofeedback and certain types of psychotherapy may be advised to decrease stress. Surgery is sometimes considered and involves cutting certain nerves supplying the muscle that is affected. The surgery is delicate and an experienced practitioner who does many of the procedure should be looked for if surgery is being considered.
Sources:
http://www.cigna.com/healthinfo/nord213.html
<http://en.wikipedia.org/wiki/Spasmodic_torticollis>
<http://www.emedicinehealth.com/torticollis/article_em.htm>
<http://www.torticollis.org/>
This article is informational only and not medical advice. Always follow up with your doctor for questions regarding you health
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