II. Definition

  1. Head and neck rotation due to sternocleidomastoid shortening

III. Signs

  1. Head laterally bent toward the shortened sternocleidomastoid muscle
  2. Chin and neck rotated toward the opposite side

IV. Causes

  1. Nondynamic Torticollis (nonparoxysmal)
    1. Congenital Torticollis
    2. Osseous Torticollis
      1. Klippel-Feil Syndrome (short neck, low occipital hair line, fused Cervical Vertebrae)
      2. Vertebral or spinal lesions
      3. Hemivertebrae or blocked Vertebrae
      4. Atlantoaxial Rotary Fixation (C1 subluxation on C2)
    3. Neurologic
      1. Posterior fossa malignancy (e.g. cerebellar or Brain Stem neoplasm)
      2. Mass lesions
      3. Chiari Malformation
    4. Ocular
      1. Congenital Cataract
      2. Microphthalmia
    5. Non-muscular soft-tissue
  2. Dynamic Torticollis (paroxysmal)
    1. Benign paroxysmal Torticollis
      1. Self limited, intermittent episodes lasting minutes to hours and recurring over weeks to months
      2. Onset in the first few months of life and resolves by age 2-3 years old
      3. May be associated with Ataxia, Nystagmus, agitation, Vomiting, lethargy, pallor
    2. Spasmodic Torticollis (Cervical Dystonia)
      1. Sleep malposition
      2. Cervical Lymphadenitis (e.g. Strep Throat, Cat Scratch Disease, Tuberculosis)
      3. Local inflammation or Trauma
      4. Retropharyngeal Abscess or Peritonsillar Abscess
      5. Upper lobe Pneumonia
    3. Sandifer Syndrome
      1. Severe GERD or esophagitis results in Torticollis, opisthotonus, irritability
    4. Medication reaction
      1. Neuroleptic induced Dystonic Reaction
    5. Increased Intracranial Pressure
      1. Pseudotumor Cerebri
    6. Conversion Disorder

V. References

  1. Jhun, Grock, Ebenezer in Herbert (2016) EM:Rap 16(7): 11-3
  2. Tomczak (2013) J Child Neurol 28(3):365-78 +PMID: 23271760 [PubMed]

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Ontology: Torticollis (C0040485)

Definition (MSHCZE) Torticollis – lat. stočení hlavy k jedné straně krku, často provázené bolestivým spasmem krčních svalů. Vzniká při porodu, některých nervových poruchách, chorobách svalů či páteře. Může jít o iritaci n. XI. vyvolanou např. ohraničenou ischemií, sclerosis multiplex, syringobulbií aj. Při malformacích krční páteře jde o t. osseus, je-li příčinou narušená funkce okohybných svalů, jde o t. ocularis, při úrazové příčině o t. posttraumaticus apod. Vrozený t. je obv. svalového původu (t. muscularis) při zkrácení m. sternocleidomastoideus. Léčí se cvičením, rehabilitací, u vrozeného t. se někdy provádí myotomie. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (MSH) A symptom, not a disease, of a twisted neck. In most instances, the head is tipped toward one side and the chin rotated toward the other. The involuntary muscle contractions in the neck region of patients with torticollis can be due to congenital defects, trauma, inflammation, tumors, and neurological or other factors.
Definition (CSP) contracted state of the cervical muscles, producing twisting of the neck and an unnatural position of the head.
Concepts Sign or Symptom (T184)
MSH D014103
ICD9 723.5
ICD10 M43.6
SnomedCT 156643008, 267979007, 275310009, 202769000, 161883001, 139139001, 202766007, 267978004, 268080005, 70070008, 270476009
English Torticollis, Wryneck, Torticollis unspecified, Torticollis, unspecified, TORTICOLLIS, wryneck, torticollis, torticollis (diagnosis), contracture of neck, contracture of neck (diagnosis), Torticollis NOS, Torticollis [Disease/Finding], neck contracture, retrocollis, torticollis unspecified, wry neck, Neck contractures, Wry neck/torticollis (& symptom), Torticollis - symptom, Torticollis (& [NOS]) (disorder), Wry neck/torticollis (finding), Torticollis (& [NOS]), Contracture of neck (finding), Wry neck/torticollis (& symptom) (finding), (Torticollis unspecified) or (contracture of neck), (Torticollis unspecified) or (contracture of neck) (disorder), Torticollis unspecified (disorder), Wry neck symptom, Torticollis NOS (disorder), Retrocollis, Wry neck, Contracture of neck, Wry neck/torticollis, Torticollis (disorder), Wry neck/torticollis (disorder), Contracture of neck, NOS, Torticollis, NOS
French TORTICOLIS, Torticolis, non précisé, Rétrocolis, Torticolis
Portuguese TORCICOLO, Torcicolo NE, Retrocolo, Torcicolo
Spanish TORTICOLIS, Torcedura de cuello, Retrocolis, Tortícolis no especificada, tortícolis, no especificada (trastorno), tortícolis, no especificada, tortícolis, no especificado, tortícolis, SAI (trastorno), contractura de cuello (hallazgo), tortícolis, SAI, tortícolis, no especificado (trastorno), contractura de cuello, contractura del cuello, cuello torcido/tortícolis (trastorno), cuello torcido/tortícolis, tortícolis (trastorno), tortícolis, Tortícolis
Dutch retrocollis, niet-gespecificeerde torticollis, scheefhals, scheve hals, torticollis, Scheve hals, Torticollis
German schiefer Hals, Retrocollis, Torticollis, unspezifisch, SCHIEFHALS, Torticollis, Schiefhals, Tortikollis
Italian Torcicollo posteriore, Contrattura dei muscoli del collo, Contrattura muscolare del collo, Torcicollo non specificato, Torcicollo
Japanese 斜頚、詳細不明, 後屈斜頚, シャケイショウサイフメイ, コウクツシャケイ, シャケイ, 斜頚, 斜頸
Swedish Nackspärr
Czech tortikolis, Krutihlav, Blíže neurčená tortikolis, Retrokolis, Tortikolis, Zkroucený krk
Finnish Kierokaula
Russian KRIVOSHEIA, КРИВОШЕЯ
Korean 기운 목
Croatian TORTIKOLIS
Polish Kręcz karku
Hungarian Retrocollis, Torticollis, Torticollis, nem meghatározott, Ferdenyak, Nyakferdülés
Norwegian Torticollis, skjev nakke