Adult-onset Idiopathic Torticollis
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]
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Epidemiology /Etiology[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
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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.[1][2][3]
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.[2]
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.[1][4]
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.[1][2][5][6]
Examination[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Key Research[edit | edit source]
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Resources
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Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References [edit | edit source]
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- ↑ 1.0 1.1 1.2 Crowner BE. Cervical dystonia: disease profile and clinical management. Phys Ther. 2007;87: 1511–1526.
- ↑ 2.0 2.1 2.2 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.
