1. SPASMODIC TORTICOLLIS

2. Is a chronic neurological movement disorder which causes head to be side flexed on affected side and rotated to opposite side.
Spasmodic (or adult-onset) torticollis is usually idiopathic.
Also known as "Cervical Dystonia" .
5% - family history.
One third have other dystonias (eg, eyelids, face, jaw, hand).
Can occur at any time from birth to adulthood, but most often it occurs in young adults(20-60)

3. Common in females.
It usually begins gradually and then reaches a point where it doesn't get any worse.
Predisposing factor – malalignment of neck at night.
It is thought to originate in the basal ganglia
A disturbance in the balance of Acetylcholine in the brain may be responsible.
The neurotransmitters or chemical messengers secreted from the basal ganglia travel through nerve pathways to certain muscles of the neck.
The increased nerve signals cause spasms to occur which cause the head to be pulled.

4. Symptoms : Spasms in neck muscles that you can't control.
Spasms - painful and even produce compression of nerve roots in the neck.
Muscles commonly involved are sternocleidomastoid, trapezius, levator scapulae and splenius capitis

5. Additional signs and symptoms include :
Enlargement of neck muscles (possibly present at birth)
Uneven shape of an infant's head from sleeping on the affected side
Elevation of the shoulder on the affected side
Stiffness in the neck muscles
Limited range of motion
Headache
Neck pain
Tremor

6. Besides rotational tilting (torticollis), the head can tilt laterally (laterocollis), forward (anterocollis), or backward (retrocollis).

7. Treatment Hot packs / Ice Massage Neck Massage
Relaxed passive movt of head in opp direction of spasmodic muscle
Passive Stretching
Temporary soft collar is useful during working and sleep to maintain proper posture till acute pain subsides.