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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Torticollis or wry neck

Torticollis is a condition in which the head is tilted tone side and the chin is elevated and turns to the opposite side. It can be congenital or acquired. It is also known as Loxia


Congenital torticollis is caused by birth defect or intrauterine malposition. It occurs due to damage to the sternocleidomastoid muscle. This leads to shortening or excessive contraction of the sternocleidomastoid muscle in the neck.

Spasmodic torticollis occurs due to disorder of central nervous system.

This results in shortening or excessive contraction of the muscle. It causes limited range of motion in both rotation and lateral bending. Sometimes a mass like sternocleidomastoid tumor may be noted.  This mass usually appears at the age of two to four weeks. The swelling disappears gradually and usually disappears by five to eight months of age.

Acquired torticollis occurs

  • Trauma to the neck
  • Tumors of skull base
  • Infections in pharynx
  • Ear infections
  • Drugs like antipsychotics, ketamine, amphetamines, cocaine,

Signs and symptoms of neck sprain

  • Limited range of motion
  • Headache
  • Head tremor
  • Neck pain
  • Stiffness of neck muscles
  • Shoulder is higher on one side of the body
  • Swelling of neck muscles

Tests and diagnosis

  • Physical examaintion
  • X-rays of neck

Complications of torticollis

  • Muscle swelling due to constant tension
  • Neurological symptoms due to compressed nerve roots

Treatment of torticollis

  • Benztropine
  • Diphenhydramine
  • Anticholinergics like baclofen
  • Muscle relaxant
  • Benzodiazepines
  • Botulinum toxin
  • Massage therapy
  • Passive stretching and positioning
  • Application of heat, traction to the cervical spine
  • Stretching exercises and neck braces
  • Surgical treatment

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