Torticollis

Torticollis Disorder

orticollis refers to a twisted neck in which the head is bent to one side, while the chin is turned to the other. It is also known as wryneck.

Stiff Neck

The word ‘torticollis’ comes from the Latin word ‘tortus’ meaning ‘twisted’ and collum meaning ‘neck’.

Torticollis affects people of all ages, mainly between 30-60 years of age. In torticollis there is flexion, extension or twisting of the neck muscles beyond their normal position.

The exact cause of torticollis is not known. Torticollis can develop slowly in a person with a family history of the disorder (spasmodic torticollis). Torticollis can also develop due to injury or in some cases as a side effect to certain medications.

Females are affected more than males. Stress and emotion can exacerbate the deformity.

Types of Torticollis

Congenital torticollis (inherited)- This type of neck deformity is present at birth and is due to changes in the genes.

Acquired torticollis (acute) – This type of neck deformity can occur overnight. It occurs due to damage to the nervous system, upper spine, or muscles. It usually lasts for few days and subsides with rest and non-steroidal anti-inflammatory drugs (NSAIDs).

The treatment of torticollis is targeted to relax the contracted neck muscles involved. Treatment might involve medications, physiotherapy, boulinum toxin injections or surgery. Timely treatment is extremely crucial, else the condition becomes permanent.

Torticollis refers to a category of disorders that result in an abnormal twisting or extension of the neck muscles. The neck begins to twist to one particular side in torticollis. Individuals with a family history of this condition may develop this condition gradually, while acute torticollis may occur in those who have suffered trauma. Torticollis may also occur as an adverse reaction to certain medications.

 

When torticollis occurs in those with a family history of the condition, it is known as spasmodic torticollis. The twisting of the muscles of the neck occurs spasmodically and the onset of the disorder is usually between the ages of 31 and 50 years. If the condition is left untreated, it may become permanent. Acute torticollis develops when the neck is bent or twisted too much beyond its normal limit. The individual may suffer discomfort when holding the head straight or while rotating the head to one side. Pain is also experienced when the head is moved towards the opposite side. The muscles of the neck on the affected side will become tender and painful. During medical examination of this condition, the doctor will also examine the motor and nerve functioning in order to rule out the possibility of injury to the spinal cord. In spasmodic torticollis, since the muscles on one side tend to abnormally contract, the head is likely to remain turned to one side only. The muscles of the neck and in the area between the shoulder and neck will also become strained and tender. In acute torticollis, the individual may find it very discomforting to turn the head to one particular side. Most cases of acute torticollis are not life threatening. In case, neck spasms occur along with other symptoms such as difficulties in swallowing or breathing, then it may be indicative that it is also affecting the central nervous system. Other such symptoms include numbness in the arms and legs, weakness, impairment of speech and difficulty in waking.

 

Treatment for torticollis involves relaxation of the neck muscles through medication. The condition generally resolves in a matter of some weeks. Some individuals may experience persisting neck problems that continue for months and even years. It is important to avoid stressful or anxious situations as stress tends to aggravate the symptoms. The symptoms appear to get better during sleep and hence it is essential to get lots of rest. Resting for brief periods of time throughout the day will also help to ease the discomfort.

What is Dystonia

 

What is dystonia? Dystonia is a medical condition where the muscles contract involuntarily. This causes an uncontrollable twisting of the affected body parts. Dystonia can affect all age groups, although it usually affects people in the age groups of 40-60 years. Dystonia is classified according to the underlying case. Primary dystonia is the case when the only symptom or sign is dystonia. After medical tests, no medical or neurological damage is identified and found to have been the cause of the dystonia. Secondary dystonia is when the symptoms of dystonia occur due to an underlying condition. This could be either an injury that affects the nervous system or neurological or genetic. Another answer to “what is dystonia” is that it is a condition that is differentiated depending on the type of body part it affects. Focal dystonia is where only one part of the body is affected while generalized dystonia is where both legs and other regions of the body are affected. Multifocal dystonia affects more than one unrelated body part while Hemidystonia affects the arm and leg on the same side of the body. Another type of dystonia is Segmental dystonia which affects adjacent body parts. Yet another solution to the answer of “what is dystonia” is that is can also be classified according to the age of onset. Early onset dystonia is when the symptoms of this disease appear during the first thirty years of a person’s life. These symptoms are usually noticed in a limb and gradually the dystonia spreads to other parts of the body as well. Late onset dystonia is when the symptoms appear in persons between the ages of 40-60 years. In these cases, most of the symptoms start in either the head or the neck or any one of the arms. The disease does not spread when there is a late onset of dystonia. Dystonia causes include such factors that are not specific in nature. Studies have shown that dystonia seems to be connected to a problem in the basal ganglia. The basal ganglia is an area in the brain that is responsible for initiating muscle contractions. Acquired dystonia occurs when the basal ganglia is damaged. The damage could be due to:-

  • Stroke
  • Drug reactions
  • A tumor
  • Deprivation of oxygen
  • Poisoning caused by carbon monoxide or lead
  • Brain trauma
  • Infection.

Now that we have the answers to “what is dystonia”, the next question is what the symptoms of dystonia are. Bear in mind that the symptoms can range from mild to severe. Some of the early symptoms of dystonia include:-

  • Cramping of the foot
  • Difficulties in speech
  • A dragging leg
  • Uncontrollable blinking
  • An involuntary pulling of the neck.

What then are dystonia cures? Due to advances in medical science, dystonia treatment has improved over the last few years. There are certain prescribed medications but they also come with side effects. Apart from medication, there are other options you can choose from as well. Physical therapy has been used in certain cases along with sensory tricks. If the above does not help surgery may be recommended. These surgeries include deep brain stimulation which is a kind of brain surgery and selective peripheral denervation. In this procedure, the doctor makes an incision in the person’s neck before cutting some of the nerve endings that are connected to the affected muscles. Some patients opt for alternative treatments for dystonia like yoga, meditation and acupuncture but the success of such treatments has not been verified as yet.