Tic Disorders

Tic disorders are defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) based on type (motor or phonic) and duration of tics (sudden, rapid, non-rhythmic, stereotyped, involuntary movements).

Torticollis

Related To Category: Adult

Torticollis occurs when a state of inadequate muscle tone in the muscles of the neck exist. These muscles, used to control the position of the head, cannot support the head properly causing the head to twist and turn to one side or to be pulled forward or backward.

Causes

Torticollis may be:

Inherited: Due to faulty genes

Acquired: Develops as a result of damage to the nervous system or muscles

If the condition occurs without a known cause, it is called idiopathic torticollis.

Torticollis may develop in childhood or adulthood. Congenital torticollis (present at birth) may occur if the fetus’ head is in the wrong position while growing in the womb, or if the muscles or blood supply to the fetus’ neck are injured.

Symptoms

Limited range of motion Limited range of motion

Headache

Head tremor

Neck pain

Shoulder is higher on one side of the body

Stiffness of neck muscles

Swelling of the neck muscles (possibly present at birth)

Exams and Tests

Various tests or procedures may be done to rule out possible causes of head and neck pain. A physical examination will show a visible shortening of the neck muscles and the head will tilt toward the affected side while the chin points to the opposite side.

Treatment

Treatment of congenital torticollis involves stretching the shortened neck muscle. Passive stretching and positioning are treatments used in infants and small children. Such treatments are often successful, especially if started within 3 months of birth.

Surgery to correct the neck muscle may be done in the preschool years, if other treatment methods fail.

Acquired torticollis is treated by identifying the underlying cause of the disorder. Application of heat, tractiontraction to the cervical spine, and massage may help relieve head and neck pain. Stretching exercises and neck braces may help with muscle spasms.

Medications used to treat this condition include an anticholinergic drug called baclofen. Injection of botulinum toxin can temporarily relieve the torticollis, but repeat injections every 3 months are usually need. Surgery is rarely used.

Outlook (Prognosis)

The condition may be easier to correct in infants and children. If the condition becomes chronic, numbness and tingling may develop as nerve roots become compressed in the neck. Botulinum toxin injections often provide substantial relief.

Possible Complications

Complications may include:

Muscle swelling due to constant tension

Neurological symptoms due to compressed nerve roots

When to Contact a Medical Professional

Call for an appointment with your health care provider if symptoms do not improve with treatment, or if new symptoms develop.

Prevention

While there is no known prevention, early treatment may prevent a worsening of the condition. Torticollis occurs when a state of inadequate muscle tone in the muscles of the neck exist. These muscles, used to control the position of the head, cannot support the head properly causing the head to twist and turn to one side or to be pulled forward or backward.

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