Spasmodic torticollis

Spasmodic torticollis (cervical dystonia) is a type of dystonia where there is spasmodic turning of the head and neck to one side. The muscles involved - trapezius and sternomastoid - may become hypertrophied. There may be dystonia elsewhere.

Prevalence of spasmodic torticollis is 0.006% (5.7 per 100,000) (1)

In the acute presentation there may be sudden pain and an inability to move the head. Commonly the condition occurs in the 15-30 age group. Passive and active movements are restricted. The head is typically held in a position flexed away from the pain.

• spasmodic torticollis is a chronic neurological disorder characterized by involuntary contractions of the cervical musculature that lead to abnormal movements and postures of the head (2)
  • additional symptoms can include jerking movements, transient spasms, shoulder elevation, stiffness/tightness, and tremor
  • at least two-thirds of patients report pain that significantly contributes to the disability associated with their disorder
  • pain is most frequently localized to the back of the neck and shoulders
    • may also involve the head, upper chest, upper arms, and other areas

Spasmodic torticollis (cervical dystonia) is rarely self-limiting. Treatment options include botulinum toxin injections into the affected muscles.

Notes:

• for information relating to acute wry neck (torticollis) see linked item

Reference:

• (1) Epidemiological Study of Dystonia in Europe (ESDE) Collaborative Group. A prevalence study of primary dystonia in eight European countries. J Neurol 2000;247(10):787-92.
• (2) Jankovic J et al. Cervical dystonia: clinical findings and associated movement disorders. Neurology 1991;41 (7): 1088-1091.