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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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In adults, acute torticollis can be caused by many different conditions; occasionally, no condition is found as a cause.

Trauma to the neck or spine can lead to torticollis. Injuries to the cervical spine or neck muscles often result in spasm of the muscles, leading to the twisting of the head, characteristic of torticollis.

Other causes include infection of the head or neck. These infections can cause an inflammatory torticollis secondary to inflamed glands and lymph nodes in the neck. The muscles overlying these lymph nodes contract. Torticollis may be associated with abscesses of the throat and upper airway, and those situations can be life-threatening. Other infections of the sinuses, ears, mastoids, jaw, teeth, or scalp can lead to torticollis.

Rarely, tumors, scar tissue, arthritis of the cervical spine, or vascular abnormalities may also cause torticollis.

Certain drugs of abuse such as ketamine, amphetamines, and cocaine as well as commonly prescribed neuroleptic drugs such as prochlorperazine (Compazine), haloperidol (Haldol), and chlorpromazine (Thorazine) can cause acute dystonia (a lack of normal muscle control). This is a condition that involves the sudden onset of involuntary contractions of the muscles of the face, neck, or back.

In addition to bending of the head to one side (acute torticollis), you may experience deviation of the eyes (oculogyric crisis) and protrusion of the tongue (buccolingual crisis). In addition to the causes above, children, infants, and newborns may also acquire torticollis from congenital causes or trauma due to childbirth. Congenital muscular torticollis is the most common cause of torticollis in infants.

Risk factors for torticollis include a family history of the disorder, congenital abnormalities of the cervical spine, taking drugs that predispose to muscular spasm, and trauma.

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