Adult-onset Idiopathic Torticollis: Difference between revisions
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'''Original Editors''' | '''Original Editors''' | ||
'''Lead Editors''' - David Cameron, John Fite, Bryan Purkey, John Winkelhaus. [[Physiopedia:Editors|Read more.]] | '''Lead Editors''' - David Cameron, John Fite, Bryan Purkey, John Winkelhaus. [[Physiopedia:Editors|Read more.]] | ||
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== Search Strategy == | == Search Strategy == | ||
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'''Search Terms:''' cervical dystonia, torticollis, adult torticollis, spasmodic torticollis, physical therapy, rehabilitation, Parkinson disease, Wilson Disease, post traumatic torticollis, | '''Search Terms:''' cervical dystonia, torticollis, adult torticollis, spasmodic torticollis, physical therapy, rehabilitation, Parkinson disease, Wilson Disease, post traumatic torticollis, | ||
'''Search Dates:''' April 5-12, 2011<br> | '''Search Dates:''' April 5-12, 2011<br> | ||
== Definition/Description<br> == | == Definition/Description<br> == | ||
Adult Torticollis, also referred to as cervical dystonia or spasmodic torticollis, is a condition in which the muscles that control the neck are locked in a sustained involuntary contraction. These contractures can commonly cause twisting, repetitive movements, or abnormal posturing of the neck. Depending on the severity, it can be a very painful condition that may lead to a great deal of distress.<ref name="Velickovic">Velickovic M, Benabou R, Brin M. Cervical Dystonia Pathophysiology and Treatment Options. Therapy In Practice. 2001;13:1921-1943.</ref> | Adult Torticollis, also referred to as cervical dystonia or spasmodic torticollis, is a condition in which the muscles that control the neck are locked in a sustained involuntary contraction. These contractures can commonly cause twisting, repetitive movements, or abnormal posturing of the neck. Depending on the severity, it can be a very painful condition that may lead to a great deal of distress.<ref name="Velickovic">Velickovic M, Benabou R, Brin M. Cervical Dystonia Pathophysiology and Treatment Options. Therapy In Practice. 2001;13:1921-1943.</ref><ref name="Crowner">Crowner BE. Cervical dystonia: disease profile and clinical management. Phys Ther. 2007;87: 1511–1526.</ref> | ||
== Epidemiology /Etiology == | == Epidemiology /Etiology == | ||
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== Characteristics/Clinical Presentation == | == Characteristics/Clinical Presentation == | ||
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== Differential Diagnosis == | == Differential Diagnosis == | ||
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Conditions the physical therapist should consider during initial evaluation and subsequent treatments include, but are not limited to: | Conditions the physical therapist should consider during initial evaluation and subsequent treatments include, but are not limited to: | ||
<br>'''Parkinson Disease:''' May present with head in a posture resembling torticollis. Will likely test positive for other nervous involvement. Tremor will be present in a sinusoidal oscillatory pattern. The therapist may also notice unsteadiness of gait, rigidity, and dyskinesia.<ref name="Crowner">Crowner BE. Cervical dystonia: disease profile and clinical management. Phys Ther. 2007;87: 1511–1526.</ref><ref name="Geyer">Geyer HL, Bressman SB. The Diagnosis of Dystonia. Lancet Neurol 2006; 5: 780-90.</ref><ref name="Parkinson Fleischman">Fleischman DA, Wilson RS. Parkinsonian Signs and Functional Disability in Old Age. Experimental Aging Research 2007; 33: 59-76.</ref> | <br>'''Parkinson Disease:''' May present with head in a posture resembling torticollis. Will likely test positive for other nervous involvement. Tremor will be present in a sinusoidal oscillatory pattern. The therapist may also notice unsteadiness of gait, rigidity, and dyskinesia.<ref name="Crowner">Crowner BE. Cervical dystonia: disease profile and clinical management. Phys Ther. 2007;87: 1511–1526.</ref><ref name="Geyer">Geyer HL, Bressman SB. The Diagnosis of Dystonia. Lancet Neurol 2006; 5: 780-90.</ref><ref name="Parkinson Fleischman">Fleischman DA, Wilson RS. Parkinsonian Signs and Functional Disability in Old Age. Experimental Aging Research 2007; 33: 59-76.</ref> | ||
'''Post-traumatic dystonia:''' History of recent trauma to the body region experiencing dystonia. Considered a type of secondary dystonia, onset of symptoms may come immediately after insult, or up to 12 months following. An estimated 5-21% of patients with cervical dystonia have a history of a trauma to the head or neck, although it is unclear whether the insult acted as the “trigger” for the condition.<ref name="Geyer">Geyer HL, Bressman SB. The Diagnosis of Dystonia. Lancet Neurol 2006; 5: 780-90.</ref> | '''Post-traumatic dystonia:''' History of recent trauma to the body region experiencing dystonia. Considered a type of secondary dystonia, onset of symptoms may come immediately after insult, or up to 12 months following. An estimated 5-21% of patients with cervical dystonia have a history of a trauma to the head or neck, although it is unclear whether the insult acted as the “trigger” for the condition.<ref name="Geyer">Geyer HL, Bressman SB. The Diagnosis of Dystonia. Lancet Neurol 2006; 5: 780-90.</ref> | ||
'''Wilson Disease:''' Wilson disease is an inherited disorder that can cause an accumulation of copper in the body. For a patient under age 40, with unexplained gradual onset of symptoms, a screen for Wilson disease is indicated.<ref name="Crowner">Crowner BE. Cervical dystonia: disease profile and clinical management. Phys Ther. 2007;87: 1511–1526.</ref><ref name="Wilson Disease">El-Youssef M. Wilson Disease. Mayo Clinic Proc. 2003; 78: 1126-1136.</ref> | '''Wilson Disease:''' Wilson disease is an inherited disorder that can cause an accumulation of copper in the body. For a patient under age 40, with unexplained gradual onset of symptoms, a screen for Wilson disease is indicated.<ref name="Crowner">Crowner BE. Cervical dystonia: disease profile and clinical management. Phys Ther. 2007;87: 1511–1526.</ref><ref name="Wilson Disease">El-Youssef M. Wilson Disease. Mayo Clinic Proc. 2003; 78: 1126-1136.</ref> | ||
'''Adult-onset idiopathic torticollis:''' Gradual onset of symptoms, with up to 75% of patients reporting concurrent neck pain. May also present with jerking movements, transient spasms, shoulder elevation, stiffness/tightness, and tremor.<ref name="Crowner">Crowner BE. Cervical dystonia: disease profile and clinical management. Phys Ther. 2007;87: 1511–1526.</ref><ref name="Geyer">Geyer HL, Bressman SB. The Diagnosis of Dystonia. Lancet Neurol 2006; 5: 780-90.</ref><ref name="Jankovic">Jankovic A, Tsui J, Bergeron C. Prevalence of cervical dystonia and spasmodic torticollis in theUnited States general population. Parkinsonism and Related Disorders 2007; 13: 411-416.</ref><ref name="Costa">Costa J, Espirito-Santo CC, Borges AA, et al. Botulinim toxin type A therapy for cervical dystonia (Review). Cochrane Library 2009; 1.</ref><br> | '''Adult-onset idiopathic torticollis:''' Gradual onset of symptoms, with up to 75% of patients reporting concurrent neck pain. May also present with jerking movements, transient spasms, shoulder elevation, stiffness/tightness, and tremor.<ref name="Crowner">Crowner BE. Cervical dystonia: disease profile and clinical management. Phys Ther. 2007;87: 1511–1526.</ref><ref name="Geyer">Geyer HL, Bressman SB. The Diagnosis of Dystonia. Lancet Neurol 2006; 5: 780-90.</ref><ref name="Jankovic">Jankovic A, Tsui J, Bergeron C. Prevalence of cervical dystonia and spasmodic torticollis in theUnited States general population. Parkinsonism and Related Disorders 2007; 13: 411-416.</ref><ref name="Costa">Costa J, Espirito-Santo CC, Borges AA, et al. Botulinim toxin type A therapy for cervical dystonia (Review). Cochrane Library 2009; 1.</ref><br> | ||
== Examination == | == Examination == | ||
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== Medical Management (current best evidence) == | == Medical Management (current best evidence) == | ||
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== Physical Therapy Management (current best evidence) == | == Physical Therapy Management (current best evidence) == | ||
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== Key Research == | == Key Research == | ||
add links and reviews of high quality evidence here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | add links and reviews of high quality evidence here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | ||
== Resources <br> == | == Resources <br> == | ||
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== Clinical Bottom Line == | == Clinical Bottom Line == | ||
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | ||
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== References == | == References == | ||
see [[Adding References|adding references tutorial]]. | see [[Adding References|adding references tutorial]]. | ||
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Revision as of 21:25, 12 April 2011
Welcome to Texas State University's Evidence-based Practice project space. This is a wiki created by and for the students in the Doctor of Physical Therapy program at Texas State University - San Marcos. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!
Original Editors
Lead Editors - David Cameron, John Fite, Bryan Purkey, John Winkelhaus. Read more.
Search Strategy[edit | edit source]
Databases: Cinahl, PubMed, Google Scholar, Cochrane Library, Ebsco
Search Terms: cervical dystonia, torticollis, adult torticollis, spasmodic torticollis, physical therapy, rehabilitation, Parkinson disease, Wilson Disease, post traumatic torticollis,
Search Dates: April 5-12, 2011
Definition/Description
[edit | edit source]
Adult Torticollis, also referred to as cervical dystonia or spasmodic torticollis, is a condition in which the muscles that control the neck are locked in a sustained involuntary contraction. These contractures can commonly cause twisting, repetitive movements, or abnormal posturing of the neck. Depending on the severity, it can be a very painful condition that may lead to a great deal of distress.[1][2]
Epidemiology /Etiology[edit | edit source]
add text here
Characteristics/Clinical Presentation[edit | edit source]
add text here
Differential Diagnosis[edit | edit source]
Conditions the physical therapist should consider during initial evaluation and subsequent treatments include, but are not limited to:
Parkinson Disease: May present with head in a posture resembling torticollis. Will likely test positive for other nervous involvement. Tremor will be present in a sinusoidal oscillatory pattern. The therapist may also notice unsteadiness of gait, rigidity, and dyskinesia.[2][3][4]
Post-traumatic dystonia: History of recent trauma to the body region experiencing dystonia. Considered a type of secondary dystonia, onset of symptoms may come immediately after insult, or up to 12 months following. An estimated 5-21% of patients with cervical dystonia have a history of a trauma to the head or neck, although it is unclear whether the insult acted as the “trigger” for the condition.[3]
Wilson Disease: Wilson disease is an inherited disorder that can cause an accumulation of copper in the body. For a patient under age 40, with unexplained gradual onset of symptoms, a screen for Wilson disease is indicated.[2][5]
Adult-onset idiopathic torticollis: Gradual onset of symptoms, with up to 75% of patients reporting concurrent neck pain. May also present with jerking movements, transient spasms, shoulder elevation, stiffness/tightness, and tremor.[2][3][6][7]
Examination[edit | edit source]
add text here
Medical Management (current best evidence)[edit | edit source]
add text here
Physical Therapy Management (current best evidence)[edit | edit source]
add text here
Key Research[edit | edit source]
add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Clinical Bottom Line[edit | edit source]
add text here
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10
References [edit | edit source]
see adding references tutorial.
- ↑ Velickovic M, Benabou R, Brin M. Cervical Dystonia Pathophysiology and Treatment Options. Therapy In Practice. 2001;13:1921-1943.
- ↑ 2.0 2.1 2.2 2.3 Crowner BE. Cervical dystonia: disease profile and clinical management. Phys Ther. 2007;87: 1511–1526.
- ↑ 3.0 3.1 3.2 Geyer HL, Bressman SB. The Diagnosis of Dystonia. Lancet Neurol 2006; 5: 780-90.
- ↑ Fleischman DA, Wilson RS. Parkinsonian Signs and Functional Disability in Old Age. Experimental Aging Research 2007; 33: 59-76.
- ↑ El-Youssef M. Wilson Disease. Mayo Clinic Proc. 2003; 78: 1126-1136.
- ↑ Jankovic A, Tsui J, Bergeron C. Prevalence of cervical dystonia and spasmodic torticollis in theUnited States general population. Parkinsonism and Related Disorders 2007; 13: 411-416.
- ↑ Costa J, Espirito-Santo CC, Borges AA, et al. Botulinim toxin type A therapy for cervical dystonia (Review). Cochrane Library 2009; 1.
