Neurosurgical Diseases and Disorders (M-Z) / Torticollis
General
Information
- Spasmodic torticollis involves a twisting of the neck to one side.
- Onset usually occurs between ages 30 and 40.
- Causes include brain lesions, mental or emotional conditions, compression
of the 11th cranial nerve, hemorrhage into the primary neck muscle, spine
infection, the spinal disease syringomyelia, brain tumors in children, and
other unknown causes.
Symptoms
- The twist of the neck to one side is intermittent in the early stages of
torticollis but eventually becomes continuous. The disorder is usually
lifelong once it develops.
- Torticollis caused by compression of the 11th cranial nerve, which
controls neck movement, usually causes horizontal head movements.
Treatment
- Non-surgical treatments include relaxation training, neuropsychiatric
evaluation and trans-epidermal neurostimulation (TENS) of the neck.
- Surgery is performed only in cases where the disorder is disabling and
fails to respond to medical treatment. Surgical procedures include:
- electrical stimulation of the dorsal nerve cord
- injection of botulinum toxin into the neck
- selective severing of spinal nerve roots
- surgery to ease pressure on the 11th
nerve
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