Torticollis

M. Amsyar Akil, Bagian THT-KL

Universitas Hasanuddin
 What is it?

• Also known as Wryneck

• Head and chin are tilted at opposite

angles, causing head to twist

• Asymmetrical Appearance

• Effected muscle:sternocleidomastoid
 What is it?
• Can exist before or at birth
• Congenital Muscular Torticollis

• Can occur during childhood up through adult

age
• Acquired/Noncongenital Muscular Torticollis

• Both cause asymmetrical appearance and function in the

neck and head of those afflicted
 Prevalence
• Less than .4% of newborns

• Torticollis does not prefer one side of

head or the other

• In CMT, ratio of boys to girls is 3:2

• Increased head size in male babies
 Prevalence
• In adults, noncongenital muscular torticollis
has an average onset of 40 years old
• Females twice as likely afflicted than males

• Usually equal distribution between right and

left side of body afflicted
• Slightly more right torticollis in older female populations
 Causes?
• Not well understood
• Almost 80 entities have been reported to
cause torticollis

• Common causes:
• Developmental disorders affecting
sternocleidomastoid muscle
• Imbalance in function of cervical muscles
• Other abnormalities in skull/cervical area
 Other Causes
• Genetic defect
• Infants position during pregnancy or delivery
• Tumors in head or neck
• Arthritis of neck
• Pseudotumors in infants
• Certain medications
• Genes
• More likely to be afflicted if family member had
torticollis or similar disorder
 Symptoms
• Adults and Children:
• Abnormal contraction of the neck
• Limited range of motion
• Stiff neck muscles
• Possible swelling and pain

• Can often be mistaken for more serious

condition
• See medical professional immediately
 Symptoms

• Infants:
• Tilting of chin
• Small mass (pseudotumor)
in neck
• Small neck spasms

• Diagnosed before 1
month old = shorter
physical therapy
 Prognosis
• Most helpful diagnosis is made early
• Not life threatening
• May self correct itself
• May be chronic and reoccurring
• Any complications may result from
compressed nerve roots
 Treatments
• Stretching and lengthening affected
neck muscles
• Applying heat, massage, analgesics
• Can be combined with TENS
• Transcutaneous Electrical Nerve Stimulation
• Medical treatment—Bacolfen or Botox
• Injection every three months
 Treatments
• Surgery in severe cases
• Patients whose pathology does not resolve
after 12 months of physical therapy or who
develops facial asymmetry
• Risk of injury to spinal nerves
 Preventive Measures
• Nearly impossible to prevent
• Become familiar with symptoms
• Seek medical attention
• Other serious conditions may be confused
for Torticollis and are not treated correctly
Any Questions?