Rheumatology
Fazal-I-Akbar Danish in Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Pain or limitation of movement at the neck:1 Torticollis: a Infantile torticollis (onset within the first 3 yr).b Spasmodic torticollis (d/t recurrent trapezius and sternomastoid spasm) – onset at 10–30 yr.2 Cervical rib.3 Anterior/posterior disc prolapse (usually C5/C6 disc prolapse → C6/C7 root compression).
100 MCQs from Dr. Brenda Wright and Colleagues
David Browne, Selena Morgan Pillay, Guy Molyneaux, Brenda Wright, Bangaru Raju, Ijaz Hussein, Mohamed Ali Ahmed, Michael Reilly in MCQs for the New MRCPsych Paper A, 2017
Tics are rapid, purposeless movements of a functionally related group of muscles. They are most commonly facial. They increase with anxiety and decrease during sleep. They may be reduced during periods of sustained attention. Myoclonic movements may be distinguished from tics as they affect a whole muscle or part of a muscle but not muscle groups. Dystonic movements are slower and more sustained than tics. Hemiballismic movements are movements of the limbs, which are coarse, intermittent and unilateral. Dyskinetic movements that tend to occur in the facial muscles, e.g., tardive dyskinesia, also affect muscle groups but are slower than tics. Torticollis involves the gradual development of tonic spasms in the neck muscles. (6, p 285)
The neck
Ashley W. Blom, David Warwick, Michael R. Whitehouse in Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Torticollis, due to muscle spasm, may suggest a disc lesion, an inflammatory disorder or cervical spine injury, but it also occurs with intracranial lesions and disorders of the eyes or semicircular canals. The ‘cock robin’ posture describes the head tilted to the side. It is important to observe the prominence of the SCM, as it may give clues to the underlying cause. In congenital torticollis, the muscle bulk is tightened and shortened, prominent on the tilted side and in atlanto-axial subluxation it is prominent on the opposite side.
Special features of superior oblique hypofunction due to tendon abnormalities
Published in Strabismus, 2021
Mohammed Aleassa, Alan Le, Joseph L. Demer
All patients gave prior written informed consent according to a protocol approved by the Institutional Review Board of the Redacted Institution, and in conformity with the US Health Information Portability and Accountability Act of 1996 and Declaration of Helsinki. Subjects were participants in an ongoing MRI study of strabismus by conducted the same principal investigator at the same institution from 1990 to 2019. This study includes both surface coil MRI and detailed clinical data, including clinical imaging of ocular motility in diagnostic positions and head tilts, alignment in diagnostic gaze positions by prism-cover testing, Hess screen testing where appropriate, and operative records if surgery was performed. From this database were selected seven patients who had SO hypofunction due to tendon abnormalities, but who did not exhibit MRI evidence of SO atrophy or reduced contractility. A comparison group was selected of 11 age-matched patients in whom MRI demonstrated unilateral neurogenic SO atrophy, defined as maximum SO cross sectional area less than the 25th percentile of normal 18. In the two groups, we tabulated evaluated symptoms, torticollis, heterotropia in diagnostic positions and head tilts, and fundus torsion.
Fourth Nerve Paresis and Ipsilateral Horner’s Syndrome: An Unusual Association
Published in Neuro-Ophthalmology, 2019
A 54-year-old woman presented with vertical diplopia and neck pain due to torticollis of recent onset. Over multiple examinations, performed on different days, mild ptosis was noted in her right eye, but the eye exhibited no weakness or daily variations, and the ice-pack test was repeatedly negative. In the primary gaze position, positive vertical deviation of six prismatic diopters was measured. No fusional amplitude was observed. Park’s and Bielschowsky tests were positive for a fourth nerve palsy (Figure 1). Anisocoria was evident, with miosis in the right eye, increasing in the dark. Twenty minutes after apraclonidine 0.5% (Iopidine 0.5%™, ALCON, Fort Worth, Texas, USA) drops were instilled in both eyes; sympathetic denervation (Horner’s Syndrome, HS) was evident on the right with lid ptosis reversion and mild mydriasis.1 The rest of the patient’s ocular exam was unremarkable. Laboratory testing (Acetylcholine receptor-AChR-antibodies) for myasthenia gravis was negative.
Long-term efficacy and safety of botulinum toxin treatment for cervical dystonia: a critical reappraisal
Published in Expert Opinion on Drug Safety, 2021
Luca Marsili, Matteo Bologna, Joseph Jankovic, Carlo Colosimo
Additionally, the suboptimal effects reported with BoNT in CD patients might be explained, at least in part, by the previous incomplete classification system [71]. If a case of torticollis is mistakenly considered as a torticaput (or vice-versa), only the wrong muscles are treated, with negative consequences for patients [72]. In the past, CD was classified into four fundamental subtypes, torticollis, laterocollis, retrocollis, and anterocollis. Since the more recent introduction of the ‘Col–Cap concept,’ a distinction was introduced between the ‘caput’ and ‘collis’ type [70], leading to an increased number of subtypes. Given that best treatment results rely mostly on the injection of the correct target muscles, a correct classification should improve the treatment results [70].
Related Knowledge Centers
- Dystonia
- Sternocleidomastoid Muscle
- Birth Defect
- Birth Trauma
- Plagiocephaly
- Benign Paroxysmal Torticollis
- Pott'S Disease
- Trapezius
- Posterior Cranial Fossa
- Pharynx