What Are Torticollis Causes and Risk Factors?
In adults, many different conditions can cause acute torticollis. Occasionally, medical professionals find no specific 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 (adenitis) and lymph nodes in the neck. The muscles overlying these lymph nodes may contract. Torticollis may be associated with abscesses of the throat, the retropharyngeal space, and upper airway, and those situations can be life threatening. Other infections of the sinuses, ears, mastoids, jaw, teeth, or scalp also 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 or dystonic reaction (a lack of normal muscle control). This is a condition involving 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), people may experience other symptoms such as 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 (CMT) is the most common cause of infant torticollis. CMT is a postural physical deformity present at birth that results from a shortening and scarring (fibrosis) of the sternocleidomastoid muscle on one side of the neck. Infants often sleep with their heads in the same position against the mattress, which can lead to plagiocephaly (flat head syndrome), which is why it often accompanies muscular torticollis.
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.