Spasmodic Torticollis

WHAT YOU SHOULD KNOW:

Spasmodic Torticollis (Inpatient Care) Care Guide

  • Spasmodic (spaz-MOD-ik) torticollis (tor-ti-KOL-is), also called cervical dystonia, is a condition where the neck muscles contract (tighten) abnormally. This contracting causes the neck to twist and the head to tilt to one side, forwards, or backwards. No one knows exactly what causes spasmodic torticollis. This condition may happen after an injury or a trauma. It may also be caused by a disorder affecting a system in the body. The body system may include the muscles and bones, spinal cord, brain, eyes, or the vestibular (balance) system. The risk of having torticollis is higher if it is present in a close family member.

  • Signs and symptoms of spasmodic torticollis may include muscle spasms, jerks, or tremors. You may also have pain in your neck or shoulder. Your neck may be larger than usual or the neck muscles may be unequal. A detailed health history and physical exam are needed to diagnose spasmodic torticollis. Tests, such as computerized tomography (CT) scan, magnetic resonance imaging (MRI), or x-rays may also be done. Treatment may include surgery and medicines that help decrease the muscle spasms. With treatment and care, symptoms of spasmodic torticollis may be relieved, and your quality of life improved.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Treatment of spasmodic torticollis may cause unpleasant effects. Botulinum toxin treatment may cause hoarseness or voice changes, dizziness, weakness, and difficulty swallowing. Injection of medicines may cause bleeding or damage to organs. Botulinum toxin may need to be done many times and may have a decreased effect over time. Other medicines may cause dry mouth, constipation (dry, hard bowel movement), and blurred vision. You may have bleeding or get an infection with surgery. If untreated, severe spasmodic torticollis may cause further problems. Your muscles may shorten, become stiff, and be unable to move. Ask your caregiver if you are worried or have questions about your condition, care, or treatment.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

You may be given the following medicines:

  • Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.

  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Tests:

Certain tests use a special dye to help organs and structures show up better. Tell caregivers if you are allergic to iodine or shellfish (lobster, crab, or shrimp), as you may also be allergic to this dye. Any of the following tests may be done:

  • Computerized tomography scan: This is also called a CT scan. An x-ray machine uses a computer to take pictures of your neck. It may be used to look for problems in your bones, muscles, brain, and blood vessels.

  • Magnetic resonance imaging: This test is called MRI. During the MRI, pictures are taken of your neck. An MRI may be used to look for problems in your muscles or bones which may be causing the condition. You will need to lie still during your MRI. Never enter the MRI room with an oxygen tank, wrist watch, or any other metal objects. This can cause serious injury.

  • C-spine x-rays: You may need cervical spine (c-spine) x-rays to check for broken bones or other problems in your neck. Several pictures may be taken of the bones in your neck. These neck bones are called vertebrae.

  • Electromyography: This is also called an EMG. An EMG is done to test the function of your muscles and the nerves that control them. Electrodes (wires) are placed on the area of muscle being tested. Needles that enter your skin may be attached to the electrodes. The electrical activity of your muscles and nerves is measured by a machine attached to the electrodes. Your muscles are tested at rest and with activity.

Treatment options:

  • Support: Supportive treatment may be given when other problems occur.

    • Feeding tube: A feeding tube may be needed when you are unable to use your mouth to eat. This may happen when you develop swallowing problems after having a botulinum toxin injection.

    • Cervical collar: A soft collar (brace) may be placed around your neck. This is done if you have too much neck muscle weakness and cannot hold your head properly. A collar may be put on to support your neck while the effect of the botulinum toxin lasts.

  • Surgery: You may need to have surgery if other treatments fail. Surgery may be done to cut the nerves that supply the affected muscles. Sometimes, the muscles of the neck may be cut or separated.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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