Non-Ophthalmological Causes of Torticollis
Gamal S. Boutros, M.D., Majeed Al-Mateen, M.D.
Torticollis is commonly used to mean abnormal head posture. The main mechanism for maintenance of the normal head position is the vestibulo-ocular reflex (VOR). Torticollis is a clinical sign associated with a variety of disorders including neurological, musculoskeletal, inflammatory, otolaryngological, postural, and traumatic. It is most commonly benign and self limited. Complete resolution is expected with treatment.
Evaluation of the patient with head tilt should include a detailed history and physical exam, particularly neurological exam. Investigations follow findings on the physical exam; cervical spine films are commonly needed. Additional radiographic investigation including an MRI may be needed in selected cases.In cases where a cause has not been found, follow-up is necessary.
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