918 results on '"Torticollis etiology"'
Search Results
2. [Grisel's syndrome : about two cases of a atlantoaxial (C1-C2) subluxation].
- Author
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Czajkowski M, Lefèbvre P, Bouchain O, Peigneux N, and Reuter G
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- Humans, Adult, Child, Male, Syndrome, Female, Atlanto-Axial Joint injuries, Joint Dislocations therapy, Joint Dislocations diagnosis, Joint Dislocations etiology, Torticollis etiology, Torticollis therapy, Torticollis diagnosis
- Abstract
Grisel's syndrome is a non-traumatic atlantoaxial (C1-C2) subluxation and one of the causes of torticollis in children. The subluxation occurs in the context of an infection in the ENT ("Ear Nose and Throat") region or following surgery. Diagnosis is based on clinical examination and radiological assessment. Treatment is typically medical and conservative, with surgical interventions reserved for recurrences and late presentations. We discuss here two cases of C1-C2 subluxation. The first case involves a 10-year-old child with subluxation following a rhinopharyngitis. This presentation is the classical manifestation of Grisel's syndrome. Prompt management led to correction of the subluxation using medical treatment and a soft Philadelphia collar. The second case involves a 34-year-old adult who developed posterior headaches after sphenoidotomy surgery. Grisel's syndrome is less common in adults, leading to clinical challenges and delayed diagnosis (> 1 month). Reduction combined with a halo vest treatment failed, and the patient required cervical arthrodesis.
- Published
- 2024
3. Sensory Trick in Cervical Dystonia with Subacute Sclerosing Panencephalitis.
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Garg D, Agarwal A, and Srivastava AK
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- Humans, Male, Female, Adult, Torticollis etiology, Torticollis physiopathology, Subacute Sclerosing Panencephalitis complications, Subacute Sclerosing Panencephalitis diagnosis, Subacute Sclerosing Panencephalitis physiopathology
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- 2024
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4. An unusual case of congenital torticollis.
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Nazer FY, Babajanyan A, and Bhurawala H
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- Humans, Torticollis etiology, Torticollis physiopathology, Torticollis congenital
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- 2024
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5. A 10-year-old child with acute torticollis and walking difficulty.
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Akcaboy M, Yildiz YT, Derinkuyu BE, and Senel S
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- Humans, Child, Male, Mobility Limitation, Acute Disease, Walking, Torticollis etiology, Torticollis diagnosis
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- 2024
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6. A 10-year-old child with acute torticollis and walking difficulty.
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Akcaboy M, Yildiz YT, Derinkuyu BE, and Senel S
- Subjects
- Humans, Child, Male, Mobility Limitation, Acute Disease, Walking, Torticollis etiology, Torticollis diagnosis
- Published
- 2024
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7. CV Junction Drug-Resistant Tuberculosis Presenting as Acquired Torticollis: A Rare Case Presentation.
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Synmon B, Siangshai F, Nongrum H, and Wezah W
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- Humans, Male, Antitubercular Agents therapeutic use, Adult, Torticollis drug therapy, Torticollis etiology, Tuberculosis, Multidrug-Resistant drug therapy, Tuberculosis, Multidrug-Resistant diagnosis
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- 2024
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8. Pediatric torticollis: clinical report and predictors of urgency of 1409 cases.
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Raucci U, Roversi M, Ferretti A, Faccia V, Garone G, Panetta F, Mariani C, Rizzotto E, Torelli A, Colafati GS, Aulisa AG, Parisi P, and Villani A
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- Humans, Male, Female, Retrospective Studies, Child, Preschool, Child, Risk Factors, Infant, Hospitalization statistics & numerical data, Adolescent, Torticollis epidemiology, Torticollis etiology, Torticollis diagnosis, Emergency Service, Hospital
- Abstract
Background: To date, the etiology and risk factors of torticollis are still poorly defined in the pediatric literature. Especially in the Emergency Department (ED) scenario, it is critical to reliably distinguish benign and transient conditions from (potentially) life-threatening disorders. This study describes the clinical characteristics of a large sample of children with torticollis. The aim of our study was to detect epidemiology, etiology and predictive variables associated with a higher risk of life-threatening conditions in acute torticollis., Methods: We conducted a pediatric retrospective study of acute torticollis over a 13-year period referred to the ED of a tertiary pediatric Hospital. We reported the characteristics in the overall sample and in two subgroups divided according to urgency of the underlying condition. Furthermore, we developed a multivariate model aimed at identifying the main clinical predictors of the need for urgent care., Results: 1409 patients were analyzed (median age 5.7 years, IQR 5.8). A history of trauma was present in 393 patients (27.9%). The symptom most frequently associated with torticollis were pain (83.5%). At least one pathological finding was found in 5.4 to 7.9% of patients undergoing further imaging. Hospitalization was required in 11.1% of cases (median duration 4 days). The most frequent etiologies of torticollis were postural cause (43.1%), traumatic (29.5%), and infective/inflammatory (19.1%). A longer time from onset of torticollis and the presence of headache or vomiting were strongly correlated with an underlying urgent condition, after adjusting for the other clinically and statistically significant variables in the bivariate analysis., Conclusion: Our study shows that an urgent condition most commonly occur in patients presenting with history of trauma or headache, vomiting and torticollis for more than 24 h should undergo further diagnostic evaluation and short-term follow-up, restricting invasive or expensive investigations to patients with clinical suspicion of an underlying harmful condition., (© 2024. The Author(s).)
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- 2024
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9. Early recognition of unilateral absence of sternocleidomastoid muscle in a newborn presenting with contralateral congenital torticollis.
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Padre JA, Callaghan H, Lim R, and Thomas N
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- Infant, Newborn, Humans, Neck Muscles diagnostic imaging, Torticollis etiology, Torticollis congenital
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2023
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10. Multipoint fixation with vascularised fibular bone graft and myotomy for atlanto-axial instability in cervical dystonia: a case report.
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Shah RS, Cogswell L, Mykula R, and Sikander ME
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- Humans, Cervical Vertebrae diagnostic imaging, Cervical Vertebrae surgery, Torticollis etiology, Torticollis surgery, Joint Instability surgery, Spinal Diseases, Myotomy, Atlanto-Axial Joint surgery, Spinal Fusion methods
- Abstract
Spinal instability is a challenging condition to manage in patients with cervical dystonia. Standard surgical stabilisation approaches may fail to cope with additional stress forces created by spasmodic muscles leading to construct failure either in the immediate or late post-operative period. Long-term stabilisation relies on the management of dystonic symptoms and adjunctive strategies to increase fusion success rate. We discuss the management of a challenging patient with translational C1/2 instability who had three metalwork failures with standard occipito-cervical fixation techniques within a 12 month period. A combined surgical approach using multipoint fixation, sternocleidomastoid myotomy and a vascularised fibular occiput-C2 bone graft successfully prevented further metalwork failure at over 2 years follow up.
- Published
- 2023
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11. Cervical dystonia following brain tumor: description of an unreported case and a systematic review of literature.
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Trinchillo A, D'Asdia MC, De Luca A, Habetswallner F, Iorillo F, and Esposito M
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- Humans, Female, Adult, Brain Neoplasms complications, Brain Neoplasms diagnostic imaging, Dystonic Disorders, Torticollis etiology
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- 2023
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12. PAllidal versus SubThalamic deep brain Stimulation for Cervical Dystonia (PASTS-CD): study protocol for a multicentre randomised controlled trial.
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Liu B, Xu J, Yang H, Yu X, and Mao Z
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- Humans, Globus Pallidus surgery, Quality of Life, Prospective Studies, Treatment Outcome, Randomized Controlled Trials as Topic, Multicenter Studies as Topic, Torticollis therapy, Torticollis etiology, Deep Brain Stimulation methods
- Abstract
Introduction: Deep brain stimulation (DBS) has been validated as a safe and effective treatment for refractory cervical dystonia (CD). Globus pallidus internus (GPi) and subthalamic nucleus (STN) are the two main stimulating targets. However, there has been no prospective study to clarify which target is the better DBS candidate for CD. The objective of this trial is to compare directly the efficacy and safety of GPi-DBS and STN-DBS, thereby instructing the selection of DBS target in clinical practice., Methods and Analysis: This multicentre, prospective, randomised, controlled study plans to enrol 98 refractory CD patients. Eligible CD patients will be randomly allocated to GPi-DBS group or STN-DBS group, with the DBS electrodes implanted into the posteroventral portion of GPi or the dorsolateral portion of STN, respectively. The primary outcome will be the improvement of symptomatic severity, measured by the changes in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) severity subscale and the Tsui scale at 3 months, 6 months and 12 months after surgery. The secondary outcomes include the improvement of the TWSTRS-disability subscale, TWSTRS-pain subscale, quality of life, mental and cognitive condition, as well as the differences in stimulation parameters and adverse effects. In addition, this study intends to identify certain predictors of DBS efficacy for CD., Ethics and Dissemination: The trial has been approved by the Medical Ethics Committee of Chinese PLA General Hospital (S2022-613-01). The results of this study will be published in international peer-reviewed journals and shared in professional medical conferences., Trial Registration Number: NCT05715138., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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13. C2 semisegmented hemivertebra - a rare anomaly presenting with torticollis.
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Aranha A and Choudhary A
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- Female, Young Adult, Humans, Adult, Cervical Vertebrae diagnostic imaging, Cervical Vertebrae abnormalities, Tomography, X-Ray Computed adverse effects, Torticollis diagnostic imaging, Torticollis etiology, Scoliosis, Neck Injuries complications
- Abstract
Background: Cervical hemivertebrae are extremely rare anomalies which usually present with restriction of neck movements and torticollis in childhood. Hemivertebrae within the craniovertebral junction have only been reported once previously in the literature. We report a case of semisegmented C2 vertebra presenting in a young adult with cervical pain and torticollis with no other associated anomalies., Case Description: A 21-year-old lady presented with a history of neck pain for the past 10 days and longstanding torticollis with head tilt to the left. Computed tomographic scan of the cervical spine revealed a semisegmented hemivertebra located laterally between the C1 lateral mass and C2 on the right side which was not associated with any other bony anomalies, scoliosis or atlantoaxial dislocation. Conservative treatment with physical therapy was the chosen therapeutic strategy., Conclusion: Hemivertebrae within the craniovertebral junction are exceedingly rare anomalies which may present with pain and deformity in childhood and are an important cause of congenital torticollis which may be associated with other spinal, craniofacial, cardiac or renal anomalies.
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- 2023
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14. Neck stiffness and bone osteolytic lesion in a 3-years old child: a case report.
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Carraro C, Rabusin M, Murru FM, Ammar L, Barbi E, Amaddeo A, and Cozzi G
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- Infant, Female, Humans, Child, Child, Preschool, Tomography, X-Ray Computed, Catecholamines, Torticollis diagnostic imaging, Torticollis etiology, Bone Diseases, Neuroblastoma diagnosis, Neuroblastoma diagnostic imaging
- Abstract
Background: Neuroblastoma is the most frequent extracranial solid tumor occurring in childhood, representing approximately 28% of all cancers diagnosed in infants. Signs and symptoms of neuroblastoma vary with the site of development of the tumor and can mimic other diseases due to its extreme clinical variability. However, torticollis is not reported in the medical literature as a leading symptom of neuroblastoma., Case Presentation: Here we report the case of a 3 years-old girl with fever and neck stiffness. Blood tests revealed a mild anemia and a rise in inflammatory markers. CT-scan showed a solid, heterogeneous, predominantly hypodense surrenal mass with eccentric calcification and extensive inhomogeneity of the vertebral metamers. Blood tests revealed raised serum levels of Neuron-Specific Enolase. At the 24-hours urine collection urinary catecholamines were greatly increased. A course of chemotherapy for neuroblastoma was promptly started with immediate clinical improvement., Conclusions: This case shows that the presence of torticollis could be a chief complaint of neuroblastoma. To our knowledge, neuroblastoma is not mentioned among life-threatening underlying conditions of torticollis in most recent literature reviews., (© 2023. Società Italiana di Pediatria.)
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- 2023
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15. Spontaneous spinal epidural hematoma in a toddler presenting with torticollis: case report and literature review.
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Hajhouji F, Benyaich Z, Laghmari M, Ghannane H, and Ait Benali S
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- Male, Infant, Humans, Child, Preschool, Laminectomy methods, Magnetic Resonance Imaging adverse effects, Spinal Cord surgery, Hematoma, Epidural, Spinal complications, Hematoma, Epidural, Spinal diagnostic imaging, Hematoma, Epidural, Spinal surgery, Torticollis diagnostic imaging, Torticollis etiology
- Abstract
Introduction: Spontaneous spinal epidural hematoma (SSEH) is a rare entity, especially in toddlers and infants. The nonspecificity of its presenting symptoms in children may be a source of delayed diagnosis., Case Description: We report the case of a 20-month-old young boy without medical history who presented with irreducible torticollis, worsened a few days later by severe tetraplegia and respiratory distress. Spinal magnetic resonance imaging (MRI) showed a posterior epidural hematoma, extending from C3 to T1 and compressing the spinal cord. An urgent decompressive surgery via an extensive laminectomy and evacuation of the clot was performed. The patient demonstrated a partial neurological recovery on follow-up., Conclusion: SSEH is a rare and serious condition that may compromise the functional and vital prognosis of the patient, hence the importance of prompt diagnosis and urgent treatment., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2023
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16. Thyroid disease in cervical dystonia.
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Kilic-Berkmen G, Scorr LM, Rosen A, Wu E, Freeman A, Silver M, Hanfelt J, and Jinnah HA
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- Humans, Surveys and Questionnaires, Odds Ratio, Torticollis epidemiology, Torticollis etiology, Thyroid Diseases complications, Thyroid Diseases epidemiology, Autoimmune Diseases
- Abstract
There are many possible etiologies for cervical dystonia (CD), but a cause cannot be identified in most cases. Most recent attention has focused on genetic causes, although a few prior studies have highlighted autoimmune mechanisms instead. Because autoimmune disorders frequently co-exist, the current study evaluated the hypothesis that autoimmune disorders might be more common in CD than neurological controls. The frequency of 32 common autoimmune disorders was evaluated using a systematic survey comparing 300 subjects with CD with 391 neurological controls. The frequency of thyroid disease was significantly higher in CD (20%) compared with controls (6%). Regression analyses that accounted for age and sex revealed an odds ratio of 4.5 (95% CI 2.5-8.1, p < 0.001). All other autoimmune disorders occurred with similar frequencies in CD and controls. Although these studies do not establish a mechanistic link between CD and autoimmune disease, they suggest the need for further attention to a potential relationship, and more specifically with thyroid disease., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Ltd. All rights reserved.)
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- 2023
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17. The tilts, twists, and turns of torticollis.
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Gross PW, Chipman DE, and Doyle SM
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- Child, Humans, Torticollis etiology, Torticollis congenital, Spinal Diseases, Brain Neoplasms complications
- Abstract
Purpose of Review: The purpose of this review is to outline the most recent understanding of torticollis in the pediatric population., Recent Findings: It is important to diagnose the underlying condition of torticollis early in childhood, as some conditions that cause torticollis may result in major developmental delays in early motor milestones. Recent studies have highlighted that many of the rarer causes of torticollis are often misdiagnosed as congenital muscular torticollis, suggesting that physicians should pay close attention to the results of clinical and radiographic examinations when patients present with torticollis., Summary: Congenital muscular torticollis is the most common cause of torticollis. Other, less common causes of torticollis include vertebral abnormalities, ocular torticollis, gastrointestinal disorders, soft tissue infections of the neck, posterior fossa tumors, and benign paroxysmal torticollis. Although rare, these differential diagnoses should be considered during a clinical work-up for a patient who presents with torticollis., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
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18. [Atlantoaxial rotatory subluxation - a cause of torticollis in children].
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Åkerstedt J, Karlsson C, and Guez M
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- Humans, Child, Child, Preschool, Radiography, Magnetic Resonance Imaging, Torticollis diagnostic imaging, Torticollis etiology, Atlanto-Axial Joint diagnostic imaging, Atlanto-Axial Joint pathology, Atlanto-Axial Joint surgery, Joint Dislocations diagnosis, Joint Dislocations diagnostic imaging
- Abstract
Atlantoaxial rotatory subluxation is an important differential diagnosis in young children with torticollis. The condition rarely results in neurological deficits. Radiological examinations such as computer tomography (CT) and magnetic resonance imaging (MRI) are useful to determine the diagnosis. It is important for doctors in all areas of healthcare to be aware of the condition, as persistent problems or surgery can be avoided by early detection and treatment.
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- 2023
19. Kawasaki disease with intervertebral disc calcification and torticollis.
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Koizumi K, Fujihara H, Makino K, Yamamoto J, Watanabe N, and Nakamura M
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- Humans, Tomography, X-Ray Computed, Torticollis diagnosis, Torticollis etiology, Mucocutaneous Lymph Node Syndrome complications, Mucocutaneous Lymph Node Syndrome diagnosis, Intervertebral Disc
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- 2023
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20. A Case Report of Acute Cervical Dystonia After Electroconvulsive Therapy.
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De Moerloose S, Geerts PJ, Vanacker P, and Lemmens GMD
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- Humans, Male, Aged, Electroconvulsive Therapy adverse effects, Torticollis etiology, Torticollis therapy
- Abstract
Competing Interests: The authors have no conflicts of interest or financial disclosures to report.
- Published
- 2022
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21. A rare case of atlantoaxial rotatory fixation after posterior calvarial vault expansion surgery in a Crouzon patient.
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Saenz A, Silva AHD, Jeelani NUO, James G, and Tahir MZ
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- Child, Male, Humans, Child, Preschool, Rotation, Cervical Vertebrae, Atlanto-Axial Joint diagnostic imaging, Atlanto-Axial Joint surgery, Atlanto-Axial Joint injuries, Torticollis diagnostic imaging, Torticollis etiology, Torticollis surgery, Joint Dislocations etiology
- Abstract
Introduction: Atlantoaxial rotatory fixation (AARF) is a rare condition that occurs most commonly in children. The torticollis caused by AARF usually presents as abnormal posturing of the head and neck, with rotation of the chin to the opposite side. AARF in children could occur due to congenital bony malformation, minor trauma, upper respiratory tract infections (Grisel's syndrome), postoperatively after head and neck (ENT) surgery, and unknown reasons. AARF in the postoperative patient is a rare and poorly understood entity., Methods: The authors present a case report of a 2-year-old boy with Crouzon Syndrome undergoing posterior calvarial vault expansion (PVE) surgery that developed AARF as a complication., Results: The authors believe that cranial vault surgery should be considered a potential risk procedure for AARF, especially if it is done in susceptible populations (syndromic craniosynostosis patients) with other underlying sequelae (tonsillar ectopia or syringomyelia). During surgery, careful attention should be paid to maintaining a neutral alignment of the patient's cervical spine as rotatory movements under anaesthesia and muscle relaxation may be contributory factors., Conclusion: AARF should be suspected and investigated in children with painful torticollis after craniofacial surgery., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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22. Torticollis as a presenting symptom of pediatric CNS tumors: A systematic review.
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Baklizi N, Raswoli M, Burges M, Moreira DC, and Qaddoumi I
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- Child, Humans, Diagnostic Imaging, Torticollis etiology, Torticollis therapy, Torticollis diagnosis, Neoplasms complications
- Abstract
To assess the frequency of torticollis as a presenting symptom of pediatric CNS tumors and its impact on pre-diagnostic symptom intervals (PSIs) and patient outcomes. We performed a systematic review of studies reporting torticollis in children with various CNS tumors. We searched PubMed for studies published from January 1972 to March 2021 in English. Case reports were included in the analysis if the following criteria were met (1) torticollis was the presenting symptom secondary to a CNS tumor (2) children <18 years of age, (3) underwent imaging intervention and (4) outcome data provided. Of 1,365 relevant articles, 45 were eligible for analysis according to our inclusion criteria representing 95 patients. Two independent investigators extracted the data, and a third investigator arbitrated discrepancies. We found that 38.9% of CNS tumors exhibited torticollis as the only presenting symptom. PSI lengths ranged from 0 to 4 years (median, 5 months) for low-grade tumors, and patient age and PSI length were inversely associated. Of patients with low-grade tumors, 23.8% received physiotherapy, in contrast with 0% of patients with high-grade tumors. PSI length also increased for patients who received rehabilitation, and 39.3% and 7.1% of patients with high-grade and low-grade tumors, respectively, died of their disease. Patients with low-grade tumors and torticollis as a primary presenting symptom were more likely to have a prolonged PSI. Therefore, CNS tumors should be considered in the differential diagnosis of acquired torticollis in children., (Copyright © 2022 Elsevier Inc. All rights reserved.)
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- 2022
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23. Posterior Surgery in the Treatment of Craniovertebral Junction Deformity with Torticollis.
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Du J, Gao X, Huang Y, Yang X, Zheng B, Liu Z, Hui H, Gao L, Wu J, Zhao Z, He B, Yan L, and Hao D
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- Humans, Postoperative Complications, Retrospective Studies, Treatment Outcome, Spinal Fusion methods, Torticollis etiology, Torticollis surgery
- Abstract
Objective: To investigate the clinical effect of posterior surgery in the treatment of craniovertebral junction (CVJ) deformities with torticollis and methods for preventing and treating complications in order to obtain a reasonable treatment strategy., Methods: From January 2007 to December 2017, 78 patients who suffered from CVJ deformities with torticollis treated by posterior surgery were analyzed. The surgical techniques were all posterior correction and fusion to restore the anatomical alignment of the craniovertebral junction. The visual analog score (VAS) and Short Form-36 (SF-36) health survey questionnaire were utilized to evaluate preoperative and postoperative neck pain, and changes in the torticollis angle and atlas-dens interval (ADI) were evaluated through anteroposterior X-ray and computed tomography. Intra- and postoperative complications were all recorded. One-way ANOVA, LSD-t test, and χ
2 test were performed to evaluate the difference between the preoperative and postoperative data., Results: The mean follow-up time was 37.4 ± 15.7 months, the average operation time was 115.6 ± 12.8 min, and the average blood loss was 170.8 ± 26.3 mL. According to the deformity site, the range of posterior correction and fusion was as follows: 38 cases of C1 -C2 , 33 cases of C0 -C2 , and seven cases of C0 -C3 . The preoperative SF-36, VAS, torticollis angle, and ADI were 42.6 ± 8.8, 4.8 ± 1.1, 37.2 ± 11.2°, and 4.9 ± 2.3 mm, respectively. The difference was significant at 3 months post operation (p < 0.05), and there was no significant difference at the final follow-up compared with 3 months post operation (p > 0.05)., Conclusion: It can objectively achieve favorable correction and satisfactory clinical effects under posterior correction and fixation for CVJ deformities with torticollis. Intra- and postoperative complications can be settled by proper management., (© 2022 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)- Published
- 2022
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24. Torticollis in a child with otalgia.
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Partha Sarathi CI, Swords C, and Bewick J
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- Child, Family, Humans, Earache, Torticollis diagnosis, Torticollis etiology
- Abstract
Competing Interests: Competing interests: We have read and understood the BMJ policy on declaration of interests and have no relevant interests to declare.
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- 2022
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25. Incidence of Congenital Muscular Torticollis in Babies from Southern Portugal: Types, Age of Diagnosis and Risk Factors.
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Minghelli B and Vitorino NGD
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- Aged, Child, Female, Humans, Incidence, Infant, Male, Portugal epidemiology, Pregnancy, Risk Factors, Muscular Diseases complications, Torticollis complications, Torticollis congenital, Torticollis etiology
- Abstract
Congenital torticollis (CMT) is the most common type of torticollis and is defined as a unilateral contracture of the sternocleidomastoid muscle resulting in lateral head tilt associated with contralateral rotation, and early detection and treatment may present a high probability of recovery of head posture symmetry. This study aimed to verify the incidence of torticollis in babies born in southern Portugal types, age of diagnosis and the risk factors. This study comprised 6565 infants born in the south of Portugal at Algarve University Hospital Center, Portimão unit during a 5-year period (January 2016 to December 2020). The cases diagnosed with torticollis referred to the Pediatrics and Pediatric Physiatrist consultations at this hospital were included. 118 babies—77 (65.3%) male and 41 (34.7%) female—were diagnosed with torticollis. The incidence of a 5-year period was 1.5%. Spontaneous vaginal delivery was prevalent (n = 56; 47.5%), with 106 (89.8%) deliveries with cephalic presentation. 53 (44.9%) cases of torticollis were classified as postural, 37 (31.4%) as muscular torticollis with joint limitation and 28 (23.7%) as congenital torticollis (with the presence of a nodule). Postural torticollis was diagnosed at an average age of 70.14 days, muscular torticollis with joint limitation at an average of 64.12 days and congenital torticollis at 33.25 days (p < 0.001). Plagiocephaly was present in 48 (40.7%) babies with torticollis (p = 0.005) and joint limitation in 53 (44.9%) babies (p < 0.001). The data obtained revealed a low incidence of CMT, with the majority being classified as postural. The age of diagnosis varied between 33 to 70 days from birth. The baby’s gender, mode of delivery and the fetal presentation during delivery did not show a statistically significant association with the presence of torticollis. Despite presenting a low incidence, it is important to mention the importance of professional health intervention in the implementation of prevention strategies.
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- 2022
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26. Acute cervical dystonia following the BNT162b2 mRNA COVID-19 vaccine.
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Algahtani HA, Shirah BH, and Alwafi E
- Subjects
- BNT162 Vaccine, COVID-19 Vaccines adverse effects, Humans, RNA, Messenger, SARS-CoV-2, COVID-19 prevention & control, Torticollis etiology, Viral Vaccines
- Abstract
The coronavirus disease of 2019 (COVID-19) pandemic is caused by a novel coronavirus SARS-Cov-2. Four major vaccine types are being used to fight against this deadly pandemic and save precious human lives. All types of vaccines have been associated with a risk of neurological complications ranging from mild to severe. Cervical dystonia occurring after a COVID-19 vaccine was not previously reported in the literature. In this article, we describe a case of acute cervical dystonia occurring after the first dose of the BNT162b2 COVID-19 vaccine. We attribute the occurrence of cervical dystonia to the vaccine due to the temporal relationship. This report adds to the literature a possible rare side effect of a COVID-19 vaccine and contributes to the limited literature on potential neurological side effects of mRNA-based vaccines. The likely mechanism is autoimmune. Further research is needed to probe and study the exact mechanism., (Copyright © 2022 Elsevier B.V. All rights reserved.)
- Published
- 2022
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27. Torticollis, Facial Asymmetry, Local Pain, and Barré-Liéou Syndrome in Connection with One-Sided Ponticulus Posticus: A Case Report and Review of the Literature.
- Author
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Li G, Wang Q, and Wang G
- Subjects
- Adult, Facial Asymmetry etiology, Facial Asymmetry surgery, Humans, Male, Pain, Quality of Life, Young Adult, Cervical Atlas abnormalities, Cervical Atlas diagnostic imaging, Cervical Atlas surgery, Posterior Cervical Sympathetic Syndrome, Torticollis diagnostic imaging, Torticollis etiology, Torticollis surgery
- Abstract
Background: Ponticulus posticus (PP) occurs frequently and may cause symptom series, including vertebrobasilar insufficiency, migraine, hearing loss, and Barré-Liéou syndrome. However, few studies to date have described surgical treatment of PP. We report a rare case of a patient who suffered from torticollis, facial asymmetry, localized pain, and Barré-Liéou syndrome in connection with PP. We also review the pertinent literature, focusing on surgical treatment for symptoms due to PP., Case Presentation: A 23-year-old male presented with the chief complaint of continuous significant dizziness to the point of losing consciousness while rotating his head to the right. Plain radiographs and computed tomography (CT) scans of the cervical spine showed a С1 anomaly with the formation of complete PP on the left (dominant) side, with acute-angled, С-shaped kinking of the vertebral artery. Resection of PP via the posterior midline was performed successfully. The patient had satisfactory postoperative relief from localized pain and Barré-Liéou syndrome, but there were no obvious changes in the torticollis and facial asymmetry observed during the 3-month follow-up period., Conclusions: This case is a rare presentation of torticollis, facial asymmetry, localized pain, and Barré-Liéou syndrome in connection with one-sided complete PP. This tetrad indicates that PP may affect the patient earlier than expected. In such situations, early diagnosis and timely surgical treatment may significantly improve patients' quality of life and avoid the development of torticollis and face asymmetry., (© 2022 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)
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- 2022
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28. Cervical Dystonia-A Rare Presentation of Spinocerebellar Ataxia Type 35.
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Thirumurugesan SL, Delhikumar CG, Karunakar P, Sugumaran R, Biswal N, and Kalatheeswaran S
- Subjects
- Humans, Spinocerebellar Ataxias complications, Spinocerebellar Ataxias diagnosis, Spinocerebellar Ataxias genetics, Torticollis diagnosis, Torticollis etiology
- Published
- 2022
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29. Clinical features and management of the developmental dysplasia of the hip in congenital muscular torticollis.
- Author
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Gou P, Li J, Li X, Shi M, Zhang M, Wang P, and Liu X
- Subjects
- Child, Humans, Infant, Male, Retrospective Studies, Developmental Dysplasia of the Hip, Hip Dislocation, Congenital complications, Hip Dislocation, Congenital diagnosis, Hip Dislocation, Congenital therapy, Torticollis congenital, Torticollis diagnosis, Torticollis etiology, Torticollis therapy
- Abstract
Purpose: A consistent relationship between CMT and DDH has been established. However, whether the presence of CMT has effect on clinical outcomes of DDH remains unanswered. This study aimed to evaluate clinical features and management of DDH in patients with CMT., Methods: We reviewed the medical records of 54 patients (91 hips) simultaneously diagnosed with DDH and CMT and included 54 patients (97 hips) with only DDH by random number method as the control group. Clinical and examination outcomes were recorded and compared, respectively., Results: The mean follow-up was 18.1 ± 14.5 months (range, 2 to 72 mo). In the DDH and CMT group, the age of initial treatment was lower (100.8 ± 92.3 vs. 229.0 ± 157.4 d, P < 0.001), and the rate of male significantly increased (42.6% vs. 11.1%, P < 0.001). Before treatment, development degree of hip was better than that of the DDH group. Therefore, patients with CMT had approximately 14 times greater odds of conservative treatment success than children in the DDH group (OR, 13.84; 95% CI, 3.16 to 60.60)., Conclusion: We concluded that CMT was not the risk factor for the failure of treatment. On the contrary, the identification of CMT may be beneficial to early discovery and treatment of DDH when we remain vigilant to perform physical exam and screen imaging of DDH for patients with CMT., (© 2021. The Author(s) under exclusive licence to SICOT aisbl.)
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- 2022
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30. Torticollis in childhood-a practical guide for initial assessment.
- Author
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Ben Zvi I and Thompson DNP
- Subjects
- Child, Diagnosis, Differential, Diagnostic Imaging, Humans, Torticollis diagnosis, Torticollis etiology, Torticollis therapy
- Abstract
Torticollis is encountered often in the paediatric setting and should be considered a presenting symptom, rather than a diagnosis. Aetiologies of torticollis are numerous, and the nomenclature describing underlying diagnosis can be confusing. Furthermore, children with torticollis typically present in the first instance to primary or secondary care rather than to the subspecialist. These factors can contribute to erroneous treatment of this patient-group which could be time critical in some instances. In this review, we discuss the common causes for torticollis and propose a simple clinical assessment tool and early management scheme that will assist in the differential-diagnosis and treatment pathway of this challenging condition.Conclusion: Torticollis can be the initial presentation of various conditions. The diagnosis and management tools provided in this article can aid in guiding paediatricians as to the correct initial management, imaging, and specialist referral. What is Known: • Torticollis in childhood is a very common presenting symptom with numerous aetiologies. • Management is complex, requires multiple clinical and imaging examinations, and is usually performed by non-specialized professionals. What is New: • A new, simple clinical-assessment tool under the acronym PINCH designed to aid paediatric general practitioners in diagnosing correctly the aetiology of torticollis. • A practical management scheme to aid in the treatment pathway of children with torticollis., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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31. Halter Traction for the Treatment of Atlantoaxial Rotatory Fixation.
- Author
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Yeung CY and Feng CK
- Subjects
- Adolescent, Child, Child, Preschool, Female, Humans, Joint Dislocations complications, Joint Dislocations diagnostic imaging, Male, Torticollis diagnostic imaging, Torticollis etiology, Treatment Outcome, Atlanto-Axial Joint diagnostic imaging, Joint Dislocations therapy, Torticollis therapy, Traction methods
- Abstract
Background: Atlantoaxial rotatory fixation (AARF) comprises a spectrum of abnormal rotational relationships between C1 (atlas) and C2 (axis). We aimed to evaluate the efficacy and long-term clinical outcomes of halter traction in treating patients diagnosed with primary AARF., Methods: We included patients <18 years of age who presented with new-onset painful torticollis, neck pain, and sternocleidomastoid muscle spasm, had an AARF diagnosis confirmed by use of 3-dimensional dynamic computed tomography, received in-hospital cervical halter traction under our treatment protocol, and were followed for ≥12 months. Radiographic and long-term clinical outcomes were analyzed., Results: A total of 43 patients (31 male and 12 female; average age of 7.9 years) satisfied the inclusion criteria. There were 5 acute, 6 subacute, and 32 chronic cases. The mean duration of initial symptoms prior to treatment was 12.1 weeks. Thirty-seven (86.0%) of the patients experienced previous minor trauma, and 6 (14.0%) had a recent history of upper-respiratory infection (Grisel syndrome). The mean duration of in-hospital traction was 17.6 days. The mean follow-up period was 8.5 years. Forty-two (97.7%) of the patients achieved normal cervical alignment after treatment. One patient (2.3%) had recurrence and received a second course of halter traction, with cervical alignment restored without any surgical intervention. No neurological deficits were noted during or after the treatment. No major complications were observed., Conclusions: Normal anatomy and restoration of cervical alignment can be achieved by cervical halter traction in most cases of AARF., Levels of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G782)., (Copyright © 2021 by The Journal of Bone and Joint Surgery, Incorporated.)
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- 2022
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32. A 10-year-old child with acute torticollis due to polymicrobial deep neck infection.
- Author
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Guri A and Scheier E
- Subjects
- Child, Emergency Service, Hospital, Humans, Neck diagnostic imaging, Point-of-Care Systems, Ultrasonography, Torticollis diagnostic imaging, Torticollis etiology
- Abstract
Torticollis in children can be a sign of a potentially dangerous disease; the correct diagnosis is not always obvious on history and physical examination. The use of point-of-care ultrasound (POCUS) helps to limit the differential diagnosis and direct appropriate further laboratory and radiology-performed evaluation. We present a case of a 10-year-old child whose deep neck infection (DNI) was timely diagnosed in the paediatric emergency department by early use of POCUS and drained under POCUS guidance after admission to the hospital. The culture from the fluid grew Eikenella corrodens, Streptococcus constellatus and Prevotella buccae This case demonstrates that DNIs occur in children with acute acquired torticollis, even without fever and demonstrates the importance of early use of POCUS in cases where DNI is a potential diagnosis. Moreover, this case emphasises the importance of microbiological identification of DNIs that can be the key to successful treatment., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2022
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33. Infantile torticollis caused by the epidural Ewing sarcoma family of tumors.
- Author
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Mitani Y, Kikuchi K, Oguma E, Kurihara J, and Fukuoka K
- Subjects
- Humans, Bone Neoplasms complications, Sarcoma, Ewing complications, Sarcoma, Ewing diagnosis, Spinal Neoplasms complications, Torticollis diagnosis, Torticollis etiology
- Published
- 2022
- Full Text
- View/download PDF
34. Cervical dystonia in Parkinson's Disease: frequency of occurrence and subtypes.
- Author
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Thiel MF, Altmann CF, and Jost WH
- Subjects
- Humans, Parkinson Disease complications, Torticollis etiology
- Published
- 2022
- Full Text
- View/download PDF
35. Torticollis as a Sole Presentation of Spondyloarthritis in a 4-Year-Old Child.
- Author
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Parikh NS, McClellan N, Koehn M, and Ganguli S
- Subjects
- Child, Preschool, Diagnosis, Differential, HLA-B27 Antigen, Humans, Syndrome, Spondylarthritis, Torticollis diagnosis, Torticollis etiology
- Abstract
Spondyloarthritis presents in various and occasionally unusual ways that imitates other diseases. Without forthcoming risk factors, such atypical presentation may elude diagnosis for months. The case presented here of a child, aged 4 years, who is negative for human leukocyte antigen B27 (HLA-B27) and with no family history of HLA-B27 related disease, who developed torticollis with neck pain and lymphadenopathy, highlights the necessity of continually evaluating a diagnosis, especially when treatment fails to produce expected results. Painful torticollis in a child with adenopathy often is infectious in nature or potentially due to Griesel syndrome when persistent. Chronic arthritis of the cervical spine may enter the differential diagnosis when torticollis is persistent, and early recognition and aggressive treatment is necessary to prevent permanent functional impairment., (© 2021 Marshfield Clinic Health System.)
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- 2021
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36. Sandifer Syndrome: A Case Report.
- Author
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Shrestha AB, Rijal P, Sapkota UH, Pokharel P, and Shrestha S
- Subjects
- Child, Child, Preschool, Humans, Syndrome, Dystonic Disorders, Gastroesophageal Reflux complications, Gastroesophageal Reflux diagnosis, Gastroesophageal Reflux drug therapy, Torticollis diagnosis, Torticollis etiology
- Abstract
Sandifer syndrome is an extra oesophageal manifestation of gastrointestinal reflux disease that usually presents with torticollis and dystonia (often mimicking epilepsy). Here, we describe a case of a four and a half years old child with convulsion, neck contortion, and irritability. Gastrointestinal reflux disease was suspected on the earlier visit of the patient based on the presenting symptom of vomiting and cough. Electroencephalogram revealed normal findings. A barium meal radiograph was performed which was insignificant for gastrointestinal reflux disease and hiatal hernia. Complete blood count showed results suggestive of iron deficiency anaemia, while the rest of the biochemical parameters and the infection screening were normal. The case was confirmed by a medication trial for gastrointestinal reflux disease. This syndrome is often misdiagnosed as infantile seizure and musculoskeletal disorder. So, physicians need to have a sound knowledge of Sandifer Syndrome while assessing a child presenting with convulsion and torticollis.
- Published
- 2021
- Full Text
- View/download PDF
37. C1-2 rotatory subluxation as a presenting sign in juvenile rheumatoid arthritis.
- Author
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Whitaker AT and Glotzbecker MP
- Subjects
- Adolescent, Child, Child, Preschool, Female, Humans, Traction, Arthritis, Juvenile complications, Atlanto-Axial Joint diagnostic imaging, Atlanto-Axial Joint surgery, Joint Dislocations diagnostic imaging, Joint Dislocations etiology, Joint Dislocations therapy, Torticollis etiology
- Abstract
Study Design: Case report., Introduction: Juvenile rheumatoid arthritis (JRA) typically presents with fever, rash, anterior uveitis, and/or joint pain. We present three cases with initial torticollis due to rotatory subluxation of C1-C2 as an initial sign of JRA., Case Reports: Three girls, ages 5-9, presented with C1-2 rotatory subluxation. Traction was able to reduce the atlanto-axial joint in all cases. Based on imaging, history, exam, and laboratory results, they were diagnosed with JRA. After reduction of the atlantoaxial joint, they were transitioned to a halo vest and disease-modifying antirheumatic drugs (DMARDs). The older 2 children underwent C1-2 fusion. The younger child has minimal symptoms and has not undergone surgical intervention 4 years from initial presentation., Conclusion: Rotatory subluxation can be the first presenting sign of JRA. Younger children may be able to be treated conservatively with traction and medication, while older children may require occiput to C2 fusion due to bony destruction and basilar invagination., Level of Evidence: IV., (© 2021. Scoliosis Research Society.)
- Published
- 2021
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38. Neck Tilt in a Child.
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Karthigeyan M and Salunke P
- Subjects
- Child, Female, Humans, Joint Dislocations surgery, Torticollis surgery, Atlanto-Axial Joint, Joint Dislocations complications, Joint Dislocations diagnostic imaging, Torticollis diagnostic imaging, Torticollis etiology
- Published
- 2021
- Full Text
- View/download PDF
39. Young Boy With Acquired Torticollis.
- Author
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Jain U, Lerman M, Sotardi S, and Delgado E
- Subjects
- Cervical Vertebrae diagnostic imaging, Humans, Infant, Magnetic Resonance Imaging, Male, Tomography, X-Ray Computed, Arthritis, Juvenile diagnostic imaging, Torticollis etiology
- Published
- 2021
- Full Text
- View/download PDF
40. Acquired Os Odentoideum Due to Cervical Dystonia in a Child With Dyskinetic Cerebral Palsy.
- Author
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Carpenter BM, Sankary KM, and Pham K
- Subjects
- Child, Family, Humans, Severity of Illness Index, Cerebral Palsy complications, Cerebral Palsy diagnosis, Torticollis diagnosis, Torticollis etiology
- Published
- 2021
- Full Text
- View/download PDF
41. Retro-Odontoid and Retro-C2 Body Pseudotumor, Pannus, and/or Cyst. A Study Based on Analysis of 63 Cases.
- Author
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Goel A, Darji H, Shah A, Prasad A, and Hawaldar A
- Subjects
- Adult, Atlanto-Axial Joint diagnostic imaging, Bone Cysts diagnostic imaging, Cervical Vertebrae surgery, Conservative Treatment, Female, Humans, Internal Fixators, Joint Instability diagnostic imaging, Joint Instability surgery, Magnetic Resonance Imaging, Male, Odontoid Process diagnostic imaging, Retrospective Studies, Spinal Cord Compression etiology, Spinal Fusion, Spinal Neoplasms diagnostic imaging, Tomography, X-Ray Computed, Torticollis etiology, Torticollis surgery, Atlanto-Axial Joint surgery, Bone Cysts complications, Bone Cysts surgery, Joint Instability therapy, Odontoid Process surgery, Spinal Neoplasms complications, Spinal Neoplasms surgery
- Abstract
Objective: The potential significance of relationship of atlantoaxial instability with retro-odontoid pseudotumor, pannus, and/or cyst (RPC) is analyzed., Methods: We searched the database of patients with craniovertebral junction-related instability treated by atlantoaxial fixation from January 2000 to March 2020. We identified 63 patients in whom there was an RPC in the region posterior to the odontoid process or posterior to the posterior aspect of the C2 body., Results: The RPC was solid in 10 patients, predominantly cystic in 39 patients, and had both solid and cystic components in 14 patients. The vertical dimension of the RPC varied from 4.5 to 10.5 mm (average, 7.9 mm) and the transverse dimension ranged from 2 to 5.2 mm (average, 3.4 mm). In 51 patients, the RPC was in the midline and in 9 patients, it was eccentric in location. In 38 patients, there was erosion of the C2 body adjoining the RPC. Analysis of investigations showed that in 100% of patients, the dome of the RPC was in line with the most susceptible point of potential bone compression of neural structures. The RPC was eccentric in location in 9 patients presenting with torticollis. RPC indicated the presence of atlantoaxial instability even when there were no other positive and validated radiologic indicators. After atlantoaxial stabilization, the RPC spontaneously regressed or disappeared. Direct resection of the RPC was neither performed nor was necessary in any case., Conclusions: RPCs are secondary consequences of atlantoaxial instability and need not be primarily addressed by surgical resection. Their location suggests that they might have a neural protective function., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2021
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42. Traumatic atlanto-axial rotatory subluxation and dens fracture with subaxial SCIWORA of Brown-Sequard syndrome: A case report.
- Author
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Kim SK, Chang DG, Park JB, Seo HY, and Kim YH
- Subjects
- Accidents, Traffic, Atlanto-Axial Joint diagnostic imaging, Brown-Sequard Syndrome etiology, Cervical Vertebrae injuries, Child, Humans, Joint Dislocations etiology, Ligaments, Articular diagnostic imaging, Ligaments, Articular injuries, Male, Neck Injuries diagnostic imaging, Neck Injuries etiology, Neck Pain diagnostic imaging, Neck Pain etiology, Radiography, Rupture, Spinal Cord Injuries etiology, Spinal Fractures etiology, Torticollis diagnostic imaging, Torticollis etiology, Atlanto-Axial Joint injuries, Brown-Sequard Syndrome diagnostic imaging, Joint Dislocations diagnostic imaging, Spinal Cord Injuries diagnostic imaging, Spinal Fractures diagnostic imaging
- Abstract
Rationale: A case of traumatic atlanto-axial rotatory subluxation (AARS), dens fracture, rupture of transverse atlantal ligament (TAL), and subaxial spinal cord injury without radiographic abnormality (SCIWORA) of Brown-Sequard syndrome has never been reported in a child., Patient Concerns: A 7-year-old boy presented to hospital with torticollis, neck pain, and limited neck rotation after a seat-belt injury sustained during a car accident. Neurologic examination revealed right-side motor weakness and left-side sensory abnormality, known as Brown-Sequard syndrome., Diagnosis: Radiologic examinations revealed type II AARS (Fielding and Hawkins classification), increased atlanto-dental interval (ADI) of 4.5 mm due to a type 1B TAL rupture (Dickman classification), a displaced transverse dens fracture along with an ossiculum terminale, and an intramedullary hemorrhage on the right side of the spinal cord at C3-4., Interventions: The patient immediately received methylprednisolone, and his motor weakness and sensory abnormality gradually improved. At the same time, the patient underwent initial halter traction for 2 weeks, but he failed to achieve successful reduction and required manual reduction under general anesthesia., Outcomes: At the 7-month follow-up visit, radiologic examinations showed a corrected type II AARS that was well maintained and normalization of the ADI to 2 mm. The reduced transverse dens fracture was well maintained but still not united. All clinical symptoms were significantly improved, except the remaining motor weakness of the right upper extremity., Lessons: To the best of our knowledge, this is the first report of traumatic AARS, dens fracture, TAL rupture, and subaxial SCIWORA of Brown-Sequard syndrome in a child. Appropriate diagnosis and careful treatment strategy are required for successful management of complex cervical injuries in a child., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2021
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43. Osteoid Osteoma of the Atlas in a Boy: Clinical and Imaging Features-A Case Report and Review of the Literature.
- Author
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Valluzzi A, Donatiello S, Gallo G, Cellini M, Maiorana A, Spina V, and Pavesi G
- Subjects
- Child, Humans, Magnetic Resonance Imaging, Male, Tomography, X-Ray Computed, Torticollis etiology, Cervical Atlas diagnostic imaging, Cervical Atlas pathology, Cervical Atlas surgery, Osteoma, Osteoid complications, Osteoma, Osteoid diagnostic imaging, Osteoma, Osteoid pathology, Osteoma, Osteoid surgery, Spinal Neoplasms complications, Spinal Neoplasms diagnostic imaging, Spinal Neoplasms pathology, Spinal Neoplasms surgery
- Abstract
Osteoid osteoma is a benign osteoblastic tumor, quite uncommon in the spine. We report a case of an osteoid osteoma involving the atlas in a 6-year-old boy, who presented with suboccipital pain and torticollis. Initial radiological findings were ambiguous as magnetic resonance imaging showed mainly edema of upper cervical soft tissues. The subsequent computed tomography depicted a lesion of left lamina of C1. As conservative treatment failed, the lesion was surgically resected and the patient became pain free. To our knowledge, this is the first case of osteoid osteoma involving the atlas associated with abnormal soft tissue reaction reported in literature., Competing Interests: None., (Thieme. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
44. A Rare Case of Nontraumatic Atlantoaxial Rotatory Fixation in an Adult Patient Treated by a Closed Reduction: A Case Report.
- Author
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Isogai N, Matsui I, Sasao Y, Nishiyama M, Funao H, and Ishii K
- Subjects
- Adult, Female, Humans, Neck Pain etiology, Radiography, Traction adverse effects, Atlanto-Axial Joint diagnostic imaging, Atlanto-Axial Joint surgery, Torticollis diagnostic imaging, Torticollis etiology, Torticollis therapy
- Abstract
Case: A 42-year-old woman presented with a severe neck pain and torticollis due to uncertain etiology. Because her radiographs and computed tomography revealed atlantoaxial rotatory fixation (AARF) that is an extremely rare condition in the adult population, a nonsurgical treatment was initially applied. Because 3 weeks of indirect traction failed, closed reduction was performed under general anesthesia at 2 months after onset, and her symptoms markedly improved without any complications and recurrence., Conclusion: Closed reduction under general anesthesia for nontraumatic AARF in adult patients might be an effective treatment option, even for chronic cases or intractable cases by traction treatment., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B355)., (Copyright © 2021 by The Journal of Bone and Joint Surgery, Incorporated.)
- Published
- 2021
- Full Text
- View/download PDF
45. Atlantoaxial rotatory subluxation/fixation and Grisel's syndrome in children: clinical and radiological prognostic factors.
- Author
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Spinnato P, Zarantonello P, Guerri S, Barakat M, Carpenzano M, Vara G, Bartoloni A, Gasbarrini A, Molinari M, and Tedesco G
- Subjects
- Child, Humans, Prognosis, Retrospective Studies, Atlanto-Axial Joint diagnostic imaging, Joint Dislocations diagnostic imaging, Joint Dislocations therapy, Torticollis diagnostic imaging, Torticollis etiology, Torticollis therapy
- Abstract
Atlantoaxial rotatory subluxation/fixation (AARS/F) is a rare cause of torticollis in children. The aim of our study is to investigate all possible clinical and radiological prognostic factors in children with AARS/F. We retrospectively reviewed all cervical spine CT scans of children with AARS/F treated in our Hospital over the last 15 years. AARS/F was classified according to Fielding and Hawkins classification and C1-C2 rotation-degree was calculated. Moreover, two orthopedic surgeons reviewed all clinical reports of these children. All patients were conservatively treated (cervical traction/neck collar). An early recovery was considered in patients with complete clinical/radiological healing at 3 months follow-up, while a late recovery was considered in patients with disease persistence or relapse at 3 months follow-up or earlier. Fifty-five patients with diagnosis of AARS/F were included in the study (mean age = 8.5 years old - 25F, 30M). In 9/55 subjects (16.4%), a late recovery was observed. The presence of a concomitant infection or inflammation in the head and neck region (Grisel's syndrome) was significantly associated with a late recovery (p < .001). Also, the type of AARS/F (p = .019), according to the Fielding and Hawkins classification, and C1-C2 rotation-degree (p = .027) were significantly correlated with the recovery time.Conclusion: In patients with AARS/F, the presence of a concomitant infection/inflammation in the head and neck region is the most important prognostic factor and it is associated with a late recovery. The Fielding and Hawkins classification and C1-C2 rotation-degree well correlate with patients' recovery time. What is Known: • Atlantoaxial rotatory subluxation/fixation (AARS/F) is a rare cause of torticollis in children and CT is the most useful imaging tool for diagnosis and classification of AARS/F. • Conservative treatments are effective in the majority of pediatric patients with AARS/F. What is New: • The presence of a concomitant infection/inflammation in the head and neck region associated with AARS/F (Grisel's syndrome) is the most important prognostic factor and it is associated with a late recovery. • C1-C2 rotation-degrees, as well as Fielding and Hawkins classification system, well correlate with patients' recovery time.
- Published
- 2021
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46. Atypical presentations of DYT1 dystonia with acute craniocervical onset.
- Author
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Pavelekova P, Jech R, Zech M, Krepelova A, Han V, Mosejova A, Liba Z, Urgosik D, Gdovinova Z, Havrankova P, Fecikova A, Winkelmann J, and Skorvanek M
- Subjects
- Adult, Child, Dystonia Musculorum Deformans complications, Dystonia Musculorum Deformans genetics, Dystonia Musculorum Deformans therapy, Female, Humans, Male, Torticollis etiology, Torticollis genetics, Torticollis therapy, Dystonia Musculorum Deformans physiopathology, Torticollis physiopathology
- Abstract
DYT1 gene mutations lead to early-onset dystonia that begins with focal limb onset and spreads to other body regions within 5 years, with typical sparing of the oromandibular muscles. In the present study, we describe two patients with an unusual presentation of the disease., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
47. Development of a questionnaire to identify ocular torticollis.
- Author
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Yoon JA, Choi H, Shin YB, and Jeon H
- Subjects
- Child, Cross-Sectional Studies, Humans, Prospective Studies, Surveys and Questionnaires, Ocular Motility Disorders diagnosis, Ocular Motility Disorders etiology, Torticollis diagnosis, Torticollis etiology
- Abstract
Ocular disease is one of the causes of abnormal head positioning. Conventionally, the behavioral characteristics of ocular torticollis patients are different from those of non-ocular torticollis patients, though research addressing the significance of this difference is yet limited. This prospective, cross-sectional study aims to develop a questionnaire based on the clinical features in children with abnormal head posture being ocularly assessed. Children aged ≥ 6 months who visited our rehabilitation medicine clinic with a chief complaint of abnormal head posture were included. Patients with apparent orthopedic and neurological diseases were excluded. A 10-item questionnaire was developed to analyze the behavioral characteristics of patients. The patients were divided into ocular and non-ocular torticollis groups according to ophthalmologic examination results. Thirty-four and 13 patients were assigned to the non-ocular torticollis and ocular torticollis groups, respectively. Five questions were finally selected and the questionnaire was scored as the sum of the scores for the each questions (yes = 1 point, no = 0 point). The median (interquartile range) score of the ocular torticollis group (3.0 (3.0-4.0)) was significantly higher than that of the non-ocular torticollis group (2.0 (1.0-3.0); p = 0.000).Conclusion: Our parent-reported torticollis assessment questionnaire may be useful for screening ocular torticollis. What is known: • Ocular disease is one of the various causes of abnormal head positioning. • The behavioral characteristics of patients with ocular torticollis are different from those of patients with non-ocular torticollis; research on this matter is limited. What is new: • We delveloped a questionnaire to differentiate ocular and postural torticollis and the score of the questionnaire was different between patients with or without ocular disease. • The questionnaire based on behavioral characteristics may help screening and determining the need of ophthalmic evaluation in patients with torticollis.
- Published
- 2021
- Full Text
- View/download PDF
48. Fibromatosis colli leading to positional plagiocephaly with gross anatomical and sonographic correlation.
- Author
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Rousslang LK, Rooks EA, Smith AC, and Wood JR
- Subjects
- Fibroma complications, Fibroma therapy, Humans, Infant, Newborn, Male, Physical Therapy Modalities, Plagiocephaly, Nonsynostotic therapy, Torticollis diagnostic imaging, Torticollis etiology, Torticollis therapy, Ultrasonography, Fibroma diagnostic imaging, Neck Muscles, Plagiocephaly, Nonsynostotic diagnostic imaging, Plagiocephaly, Nonsynostotic etiology, Torticollis congenital
- Abstract
Fibromatosis colli, also known as 'sternocleidomastoid tumour of infancy' or 'pseudotumour of infancy', is a rare condition involving fibrosis and swelling, or 'tumour' of the sternocleidomastoid muscle in newborns that typically occurs after a traumatic delivery. Although usually self-limited, fibromatosis colli can lead to congenital muscular torticollis and positional plagiocephaly due to uneven forces on the neonatal skull. Ultrasound is the diagnostic imaging modality of choice and can prevent additional imaging and unnecessary intervention., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
- Full Text
- View/download PDF
49. Fever, Torticollis, and Rash in a Young Boy-Is This Kawasaki Disease?
- Author
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Jindal AK, Suri D, Sinha A, Sharma M, Rawat A, and Singh S
- Subjects
- Fever diagnosis, Fever etiology, Humans, Male, Exanthema diagnosis, Exanthema etiology, Mucocutaneous Lymph Node Syndrome complications, Mucocutaneous Lymph Node Syndrome diagnosis, Torticollis diagnosis, Torticollis etiology
- Abstract
Competing Interests: The authors declare no conflict of interest.
- Published
- 2021
- Full Text
- View/download PDF
50. The Spectrum of Underlying Diseases in Children with Torticollis.
- Author
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Tumturk A, Gorkem SB, Ozmansur EN, Peduk Y, Arslan U, Gok V, Dogan H, Cetin BS, Sahin A, Gumus H, Guney A, Unal E, Kurtsoy A, and Per H
- Subjects
- Adolescent, Child, Child, Preschool, Ependymoma, Female, Humans, Infant, Male, Physical Examination, Retrospective Studies, Brain Neoplasms complications, Calcinosis complications, Eye Diseases complications, Neck Pain etiology, Spinal Diseases complications, Torticollis etiology
- Abstract
Aim: To investigate the underlying conditions in children with torticollis., Material and Methods: Between May 2016 and December 2019, 24 patients (10 girls and 14 boys; mean age, 8 years) presenting with twisted neck, neck pain, weakness of extremities, imbalance, and gait disorder were evaluated retrospectively., Results: Five of the patients had cranial pathologies (cerebellar anaplastic ependymoma and medulloblastoma, brain stem glioma, atypical teratoid rhabdoid tumor, and acute disseminated encephalomyelitis), and five of the patients had spinal pathologies (idiopathic intervertebral disc calcification, vertebral hemangiomatosis, compression fracture, multiple hereditary exostoses, and Langerhans cell histiocytosis at C4). Six of the patients had ocular pathologies (strabismus, Duane syndrome, and Brown syndrome each in two patients). Four patients had otorhinolaryngological infections (Sandifer syndrome, esophageal atresia, reflux, and spasmus nutans, with one patient each). Detailed clinical physical examination and necessary laboratory investigation were performed for all patients., Conclusion: Torticollis is a sign that is not always innocent and may herald an underlying severe disease. Misdiagnosis can lead to wrong and unnecessary surgical procedures and treatments, and sometimes, the results can be damaging due to underlying severe conditions if diagnosed late. In addition, we first report a case of vertebral hemangiomatosis and temporomandibular joint ankylosis that presented with torticollis in the English medical literature.
- Published
- 2021
- Full Text
- View/download PDF
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