Posttraumatic torticollis
D. D. Truong, R. Dubinsky, N. Hermanowicz, W. L. Olson, B. Silverman and W. C. Koller
Department of Neurology, University of California, Irvine, Orange 92668.
We report six cases of torticollis precipitated by neck trauma. The
dystonia began 1 to 4 days after the trauma and differed clinically from
idiopathic torticollis by marked limitation of range of motion, lack of
improvement after sleep ("honeymoon period"), and absence of geste
antagonistique. Worsening with action was not present; nor was there
improvement with support as seen with idiopathic torticollis. Onset of pain
immediately after the trauma and marked spasms of the paracervical muscles
were other predominant features. Anticholinergic therapy was without
benefit; however, some improvement occurred with botulinum toxin injection.
It is concluded that torticollis can be caused by peripheral trauma and
that it has unique clinical characteristics.
