SPASMODIC TORTICOLLIS (Wry Neck)

This is a condition characterized by involuntary movements affecting many cervical muscles on both sides of the neck. It may occur as the sole manifestation of disease of the extrapyramidal system, or it may be associated with other signs. Torticollis may also occur as a manifestation of hysteria or as a tic. The onset is usually insidious except in hysterical cases when it is often sudden following emotional disturbance. The movements consist of spasmodic rotation, flexion and extension of the cervical spine in the antero-posterior and lateral planes.

Diagnosis

Congenital torticollis due fibrosis following haematoma of one sternomastoid muscle is present from birth. Local disease of the cervical spine, muscles or lymph glands may also cause torticollis.

Treatment

Spasmodic torticollis is a particularly intractable condition. Physiotherapy and sedation are employed but the results are usually disappointing. Surgical division of the spinal accessory nerves or of the cervical nerves may be tried if disability is intolerable.

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