Acquired torticollis

Обзор 
Теория 
Диагноз 
Лечение 
Последующее наблюдение 
Источники 

Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Последний просмотренный: 25 Nov 2025

Last updated: 17 Nov 2022

Acquired torticollis (cervical dystonia) is a rare, typically idiopathic, brain disorder causing involuntary neck movements.

Often associated with pain.

Patients may be able to relieve their symptoms by touching their neck, head, or face in a certain way (sensory trick).

Targeted intramuscular injection of botulinum toxin is the therapy with the best proven efficacy. Oral medications and physical therapy may also have a role in the treatment of the condition.

Treatment options for refractory acquired torticollis include deep brain stimulation, radiofrequency ablation, selective surgical denervation, chemical denervation, and intrathecal baclofen.

Определение

Acquired torticollis, also known as cervical dystonia, is a focal abnormality of muscle tone that originates in the brain. It is characterized by involuntary contraction of neck muscles, abnormal neck movements, and an awkward posture of the head and neck. It is frequently associated with pain in the associated muscle groups.

Анамнез и осмотр

Ключевые диагностические факторы

involuntary twisting or deviation of the neck
neck pain
presence of sensory trick
abnormal head posture
otherwise normal neurologic exam

Полная информация

Другие диагностические факторы

head tremor
insidious onset
headache
asymmetrical hypertrophy of neck muscles
normal range of motion (ROM) of neck (early in course)

Полная информация

Факторы риска

female sex
middle age (40 to 59 years)
white ancestry
family history of acquired torticollis
exposure to dopamine-blocking drugs
history of trauma

Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

clinical diagnosis

Полная информация

Исследования, проведение которых нужно рассмотреть

cervical x-rays
CT or MRI of the brain
CT or MRI of the neck
DYT-1 gene
serum ceruloplasmin, urinary copper excretion
electromyography

Полная информация

Алгоритм лечения

Острый

without pain or functional impairment

with functional impairment or pain or diminished quality of life

ПРОДОЛЖЕНИЕ

refractory to therapy with botulinum toxin

Составители

Авторы

David B. Sommer, MD, MPH

Neurologist and Movement Disorder Specialist

Reliant Medical Group

Worcester

Раскрытие информации

DBS declares that he has no competing interests.

Выражение благодарностей

Dr David B. Sommer would like to gratefully acknowledge Dr Mark A. Stacy, a previous contributor to this topic.

Раскрытие информации

MAS has received speaking honoraria and consulting fees from Allergan, the manufacturer of Botox; he has received research grant support from Ipsen, manufacturer of Dysport, and Merz, manufacturer of Xeomin; he is an author of a reference cited in this topic. Duke University has received funding from Allergan for a continuing medical education program.

Рецензенты

Allison Brashear, MD

Professor and Chair

Department of Neurology

Wake Forest University Baptist Medical Center

Winston Salem

Раскрытие информации

AB declares interests in Allergan; she is an author of a reference cited in this topic.

Robert Werner, MD

Professor

Chief of PM&R

Ann Arbor VA Medical Center

Ann Arbor

Раскрытие информации

RW declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Stacy M. Epidemiology, clinical presentation, and diagnosis of cervical dystonia. Neurol Clin. 2008 May;26(suppl 1):23-42. Аннотация

Singer C, Velickovic M. Cervical dystonia: etiology and pathophysiology. Neurol Clin. 2008 May;26(suppl 1):9-22. Аннотация

Colosimo C, Suppa A, Fabbrini G, et al. Craniocervical dystonia: clinical and pathophysiological features. Eur J Neurol. 2010 Jul;17(suppl 1):15-21. Аннотация

Rodrigues FB, Duarte GS, Marques RE, et al. Botulinum toxin type A therapy for cervical dystonia. Cochrane Database Syst Rev. 2020 Nov 12;11:CD003633.Полный текст Аннотация

Dashtipour K, Lew M. Cervical dystonia. In: Stacy MA, ed. Handbook of dystonia. New York, NY: Informa Healthcare; 2007:137-53.

Jankovic J, Leder S, Warner D, et al. Cervical dystonia: clinical findings and associated movement disorders. Neurology. 1991 Jul;41(7):1088-91. Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия
- Arthritis of cervical spine
- Neck mass
- Cerebral mass, lesion or infarct
Больше Отличия
Рекомендации
- Practice guideline update summary: botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache
- EFNS guidelines on diagnosis and treatment of primary dystonias
Больше Рекомендации
Лифлеты для пациента
Depression in adults: what is it?
Parkinson disease: what is it?
Больше Лифлеты для пациента
Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Использование этого контента попадает под действие нашего заявления об отказе от ответственности

Acquired torticollis

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

Другие диагностические факторы

Факторы риска

Диагностические исследования

Исследования, которые показаны в первую очередь

Исследования, проведение которых нужно рассмотреть

Алгоритм лечения

without pain or functional impairment

with functional impairment or pain or diminished quality of life

refractory to therapy with botulinum toxin

Составители

Авторы

David B. Sommer, MD, MPH

Раскрытие информации

Выражение благодарностей

Раскрытие информации

Рецензенты

Allison Brashear, MD

Раскрытие информации

Robert Werner, MD

Раскрытие информации

Peer reviewer acknowledgements

Disclosures

Список литературы

Основные статьи

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия

Рекомендации

Лифлеты для пациента

Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Войдите в учетную запись, чтобы получить полноценный доступ к BMJ Best Practice