Acquired torticollis
Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- involuntary twisting or deviation of the neck
- neck pain
- presence of sensory trick
- abnormal head posture
- otherwise normal neurologic exam
Otros factores de diagnóstico
- head tremor
- insidious onset
- headache
- asymmetrical hypertrophy of neck muscles
- normal range of motion (ROM) of neck (early in course)
Factores de riesgo
- female sex
- middle age (40 to 59 years)
- white ancestry
- family history of acquired torticollis
- exposure to dopamine-blocking drugs
- history of trauma
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- clinical diagnosis
Pruebas diagnósticas que deben considerarse
- cervical x-rays
- CT or MRI of the brain
- CT or MRI of the neck
- DYT-1 gene
- serum ceruloplasmin, urinary copper excretion
- electromyography
Algoritmo de tratamiento
without pain or functional impairment
with functional impairment or pain or diminished quality of life
refractory to therapy with botulinum toxin
Colaboradores
Autores
David B. Sommer, MD, MPH
Neurologist and Movement Disorder Specialist
Reliant Medical Group
Worcester
MA
Divulgaciones
DBS declares that he has no competing interests.
Agradecimientos
Dr David B. Sommer would like to gratefully acknowledge Dr Mark A. Stacy, a previous contributor to this topic.
Divulgaciones
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.
Revisores por pares
Allison Brashear, MD
Professor and Chair
Department of Neurology
Wake Forest University Baptist Medical Center
Winston Salem
NC
Divulgaciones
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
MI
Divulgaciones
RW declares that he has no competing interests.
Agradecimiento de los revisores por pares
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Stacy M. Epidemiology, clinical presentation, and diagnosis of cervical dystonia. Neurol Clin. 2008 May;26(suppl 1):23-42. Resumen
Singer C, Velickovic M. Cervical dystonia: etiology and pathophysiology. Neurol Clin. 2008 May;26(suppl 1):9-22. Resumen
Colosimo C, Suppa A, Fabbrini G, et al. Craniocervical dystonia: clinical and pathophysiological features. Eur J Neurol. 2010 Jul;17(suppl 1):15-21. Resumen
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.Texto completo Resumen
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. Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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- Neck mass
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Más DiferencialesGuías de práctica clínica
- 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
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