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9.02 Torticollis (Wry Neck)


The patient complains of neck pain and is unable to turn his head, usually holding it twisted to one side, with some spasm of the neck muscles, with the chin pointing to the other side. These symptoms may have developed gradually, after minor turning of the head, after vigorous movement or injury, or during sleep The pain may be in the neck muscles or down the spine, from the occiput to between the scapulae. Spasm in the occipitalis, sternocleidomastoid, trapezius, splenius cervicis, or levator scapulae muscles can be the primary cause of the torticollis, or it can be secondary to a slipped facette, herniated disc, or viral or bacterial infection.

What to do:

What not to do:


Although torticollis may signal some underlying pathology, usually it is a local musculoskeletal problem--only more frightening and noticeable for being in the neck--and need not always be worked up comprehensively when it first presents in the ED.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
Mark Smith, MD
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Michael Gillam, MD