Torticollis: (Wryneck)

Presentation

The patient, usually a young or middle-aged adult, complains of neck pain and is unable to turn the head, usually holding it twisted to one side, with involuntary spasm of the neck muscles and the chin pointing to the other side. Attempts at movement generally cause the pain to worsen. These symptoms may have developed gradually, after minor turning of the head, after vigorous exercise, or overnight during sleep. Spasm in the occipitalis, sternocleidomastoid, trapezius, splenius cervicis, or levator scapulae may be visible and/or palpable ( Fig. 131.1 ).