Acute Juvenile Cervical Torticollis


Review Sections

Acute Juvenile Cervical Torticollis Icon    Acute Juvenile Cervical Torticollis

Acute juvenile cervical torticollis is a descriptive term that encompasses several different diagnoses. Some of the causes of torticollis are life threatening or can lead to long term morbidity. A thorough examination is necessary to rule out serious pathology. The clinical reviews will primarily discuss the potentially serious condition atlantoaxial rotation fixation (AARF) and the relatively benign muscular torticollis (MT). Both conditions typically resolve quickly, however the physician must be aware if AARF is slow to respond to treatment possible serious sequela are possible. According to Roche et al if an AARF is detected and resolved within 1 month the prognosis is good and after 1 month it is guarded. Cervical fusion is recommended when there is neurological involvement, anterior displacement of C1 on C2, failure to achieve correction and presence of AARF for over 3 months (1).

(1) Roche CJ, O'Malley M, Dorgan JC, Carty HM. A pictorial review of atlanto-axial rotatory fixation: key points for the radiologist. Clin Radiol 2001 Dec;56(12):947-58.

Clinical Reviews

Acute Juvenile Cervical Torticollis: Prevention

A common presentation of acute juvenile cervical torticollis (AJCT) in the chiropractor’s office is a young patient experiencing a painful sternocleidomastoid (SCM) spasm of short duration which usually resolves rapidly after initiation of treatment. Cause of the spasm can be due to an atlantoaxial rotatory fixation (AARF), a potentially serious condition, or muscular and/or ligamentous etiology.

Acute Juvenile Cervical Torticollis: Diagnosis

Acute juvenile cervical torticollis (AJCT) is more of a descriptive term than a diagnostic term. For the purposes of this monograph AJCT will be used to describe the young patient that presents in acute pain with head tilt and cervical rotation that responds rapidly to care. The reader should be cautioned there are several variations of AJCT that can have life threatening or long term consequences. Bredenkamp and Maceri state “nearly 80 entities have been associated with torticollis”. Several of these entities, which may manifest as torticollis, represent serious conditions which must be ruled out. Just a few of the conditions which have been identified in the literature are retropharyngeal abscess, bacterial meningitis, fracture, neoplasm and cervical dystonia. The scientific literature also has several different terms to describe variations of torticollis. Among these are atlantoaxial rotary subluxation (AARS), atlantoaxial rotary fixation (AARF), acquired torticollis, inflammatory torticollis, acute torticollis, Grisel’s syndrome and muscular torticollis (MT).

Acute Juvenile Cervical Torticollis: Therapy

There are possible severe consequences for a missed or delayed diagnosis in acute juvenile cervical torticollis (AJCT). The ability to eliminate other causative factors and to distinguish between atlantoaxial rotation fixation (AARF) and simple muscular torticollis (MT) is of paramount importance.

Medical Subject Heading (MeSH) Information

MeSH Term: Torticollis

Scope Note: A symptom, not a disease, of a twisted neck. In most instances, the head is tipped toward one side and the chin rotated toward the other. The involuntary muscle contractions in the neck region of patients with torticollis can be due to congenital defects, trauma, inflammation, tumors, and neurological or other factors.

MeSH Synonyms:
  • Torticollis
  • Wryneck
  • Spasmodic Torticollis
  • Torticollis, Spasmodic
  • Cervical Dystonia
  • Torticollis, Psychogenic
  • Psychogenic Torticollis
  • Torticollis, Intermittent
  • Intermittent Torticollis
Applicable MeSH Subheadings:
  • analysis
  • anatomy and histology
  • blood
  • cerebrospinal fluid
  • chemically induced
  • classification
  • complications
  • congenital
  • diagnosis
  • diagnostic imaging
  • drug therapy
  • economics
  • embryology
  • enzymology
  • epidemiology
  • ethnology
  • etiology
  • genetics
  • history
  • immunology
  • metabolism
  • microbiology
  • mortality
  • nursing
  • organization and administration
  • pathology
  • physiology
  • physiopathology
  • prevention and control
  • psychology
  • rehabilitation
  • statistics and numerical data
  • surgery
  • therapy
  • urine
  • veterinary
  • virology

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