Torticollis (Wryneck)

A symptom, not a disease, of a twisted neck. In most instances, the head is tipped toward one side and the chin rotated toward the other. The involuntary muscle contractions in the neck region of patients with torticollis can be due to congenital defects, trauma, inflammation, tumors, and neurological or other factors.

Also Known As:

Networked: 984 relevant articles (134 outcomes, 141 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Blepharospasm
2.	Hemifacial Spasm
3.	Dystonia (Limb Dystonia)
4.	Pain (Aches)
5.	Torticollis (Wryneck)

Experts

1.	Jankovic, Joseph: 19 articles (02/2015 - 03/2004)
2.	Dressler, D: 11 articles (03/2014 - 01/2000)
3.	Dressler, Dirk: 10 articles (02/2015 - 01/2002)
4.	Bhatia, Kailash P: 10 articles (09/2014 - 01/2002)
5.	Aoki, K Roger: 9 articles (04/2015 - 03/2006)
6.	Atassi, M Zouhair: 8 articles (04/2015 - 03/2006)
7.	Bhatia, K P: 8 articles (06/2013 - 01/2001)
8.	Truong, Daniel: 7 articles (08/2015 - 07/2005)
9.	Comella, Cynthia L: 7 articles (01/2015 - 07/2005)
10.	Charles, P David: 7 articles (07/2014 - 03/2004)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Torticollis:

1.	Botulinum Toxins (Botulinum Toxin)IBA 12/01/2006 - "Currently, the best treatment option for idiopathic cervical dystonia (ICD) is injection of botulinum toxin (BTX) into the affected muscles, whereas rehabilitative approaches have given disappointing results. " 03/01/2005 - "The use of botulinum toxin to treat cervical dystonia (CD) has dramatically improved the quality of life of patients with this disabling, often painful disease. " 11/01/2001 - "Botulinum toxin has dramatically improved the treatment of cervical dystonia. " 01/01/2001 - "The use of botulinum toxin to treat cervical dystonia (CD) has dramatically improved the quality of life of patients with this disabling, often painful disease. " 02/01/1990 - "We conclude that botulinum toxin is a safe and effective therapy for most patients with cervical dystonia."
2.	Type A Botulinum Toxins (Botulinum A Toxin)FDA Link 01/01/2014 - "The first-line treatment for cervical dystonia (CD) is botulinum toxin type A (BoNT-A), which has been established as a highly effective and well-tolerated therapy. " 10/01/2015 - "Botulinum neurotoxin A (BoNT A) is the first-line treatment for cervical dystonia. " 01/01/2002 - "[Prognostic factors of long-standing improvement in cervical dystonia, treated with botulinum A toxin]." 01/01/1990 - "Five patients with Idiopathic Spasmodic Torticollis (IST), one associated with Meige's disease, have been cured by local injection of purified botulinum "A" toxin (BT). " 01/01/2012 - "Factors influencing response to Botulinum toxin type A in patients with idiopathic cervical dystonia: results from an international observational study."
3.	rimabotulinumtoxinBFDA Link 02/01/2005 - "Short-term studies of cervical dystonia (CD) have demonstrated botulinum toxin type B (Bot B) to be safe and efficacious at doses of 5,000 to 10,000 units, but few long-term studies have been published and the safety and efficacy of higher doses has not been established. " 09/01/2005 - "Efficacy of botulinum toxin type B (BoNT B) for the treatment of type A-resistant (AR) and non-A-resistant (NAR) cervical dystonia (CD) has been demonstrated in several single injection studies. " 01/01/2000 - "The safety and efficacy of botulinum toxin type B in the treatment of patients with cervical dystonia: summary of three controlled clinical trials." 09/01/2012 - "Immunogenicity and long-term efficacy of botulinum toxin type B in the treatment of cervical dystonia: report of 4 prospective, multicenter trials." 11/01/2010 - "Evaluate the safety and efficacy of a sequential dose escalation of rimabotulinumtoxinB (BoNT-B) in cervical dystonia (CD) subjects. "
4.	onabotulinumtoxinA (Botox)FDA Link 10/01/1993 - "Botox F is an effective treatment for torticollis in patients who are immune to botox A. " 09/01/2012 - "Efficacy, tolerability, and immunogenicity of onabotulinumtoxina in a randomized, double-blind, placebo-controlled trial for cervical dystonia." 01/01/2001 - "A study of BTX-A demonstrated improvement of 5.15 to 10.65 degrees in head position using the Cervical Dystonia Severity Scale (CDSS) in those treated with BTX-A (trade name BOTOX) compared with placebo. " 02/15/2015 - "The Cervical Dystonia Patient Registry for Observation of OnabotulinumtoxinA Efficacy (CD PROBE; NCT00836017) is a prospective, observational, multicenter, real-world registry designed to assess the safety, effectiveness, and treatment utilization following multiple treatments of onabotulinumtoxinA. " 02/15/2015 - "Primary results from the cervical dystonia patient registry for observation of onabotulinumtoxina efficacy (CD PROBE)."
5.	abobotulinumtoxinAFDA Link 12/01/2001 - "Although individual dose titration and muscle selection is desirable, this study demonstrated that a dose of 500 units of Dysport injected into clinically identified neck muscles without electromyographic guidance is safe and effective in the treatment of patients with the major clinical types of cervical dystonia." 01/01/2002 - "Our findings suggest that low-dose treatment of cervical dystonia with Dysport may be clinically effective during maintenance therapy, at least for a limited period of time. " 08/01/1995 - "We conclude that a dosage of 200-400 mouse units BTA (Dysport) may also be effective in the treatment of cervical dystonia, but with fewer side effects. " 01/01/2001 - "Several studies have shown that 500 units Dysport are safe and effective in the treatment of cervical dystonia. " 07/01/2005 - "This multicenter, double-blind, randomized, controlled trial assessed the safety and efficacy of Dysport in cervical dystonia patients in the United States. "
6.	CosmeticsIBA 09/01/2010 - "We present a case of a 7-year-old Caucasian boy who was born with torticollis and a cosmetic defect in his neck. " 05/01/1986 - "While corrective surgery has usually been done on an elective basis for cosmetic purposes, there is evidence that uncorrected torticollis can cause musculoskeletal problems. " 07/01/2012 - "From this modest and limited beginning, it has found use for treatment of a plethora of cosmetic, neuromuscular, and skeletal disabilities, including cervical dystonia, blepharospasm, and temporary improvement in the appearance of moderate to severe glabellar lines. " 02/01/1995 - "Surgical correction of muscular torticollis in the older children is of benefit for functional and cosmetic recovery, but facial asymmetry is irreversible after 12 years of age." 01/01/2010 - "Since its discovery by Justinus Kerner, BoNT has seen use in a wide range of cosmetic and non-cosmetic conditions such as cervical dystonia, cerebral palsy, migraines and hyperhidrosis. "
7.	xeominFDA Link 12/01/2013 - "A randomized, double-blind study of repeated incobotulinumtoxinA (Xeomin(®)) in cervical dystonia." 12/01/2009 - "Xeomin in the treatment of cervical dystonia." 03/01/2012 - "Xeomin(®) 's therapeutic efficacy against cervical dystonia, blepharospasm and spasticity has been proven in large randomised, double-blind and placebo-controlled studies leading to registrations in many countries. " 11/15/2010 - "The FDA has approved incobotulinumtoxinA (Xeomin--Merz) for treatment of cervical dystonia and blepharospasm in adults. " 12/01/2009 - "In the largest controlled study of BoNT/A published to date (Neurology 2005; 64: 1949), it was demonstrated that Xeomin is non-inferior to Botox and has 1:1 efficacy in the treatment of cervical dystonia. "
8.	Myoclonic dystoniaIBA 01/01/2002 - "The most beneficial results have been achieved in patients with primary genetic generalized and segmental dystonia, myoclonic dystonia, and complex cervical dystonia. " 07/01/2006 - "In 14 patients with spasmodic torticollis, generalized dystonia, and myoclonic dystonia, surface EMG signals were recorded from the most affected muscle groups. " 05/01/1985 - "In seven of the eight patients who improved (one with segmental dystonia, one with myoclonic dystonia, two with spasmodic torticollis, two with cranial dystonia, and two with tardive dystonia), the response was confirmed by double-blind placebo substitution. " 03/01/2002 - "We studied the effects on heart rate (HR) and mean arterial blood pressure (MAP) of electrically stimulating the thalamus and basal ganglia in awake humans undergoing neurosurgery for movement disorders (n = 13 Parkinson's disease, n = 1 myoclonic dystonia, n = 1 spasmodic torticollis). " 12/01/2004 - "The electrodes were sourced from two patients with Parkinson's disease, one with myoclonic dystonia, two with cervical dystonia and five with primary generalized dystonia, and had been in situ for 11 and 31 months (Parkinson's disease), 16 months (myoclonic dystonia), 14 and 24 months (cervical dystonia) and 3-24 months (primary generalized dystonia). "
9.	batrachotoxinin A 20-alpha-benzoateIBA 04/01/2003 - "BTX-B was approved for use in cervical dystonia in 2000, but it has been used off-label to treat facial wrinkles as reported in several open-label studies. " 01/01/2001 - "A study in patients who continued to respond to BTX-A and a similarly designed study in patients who were resistant to BTX-A demonstrated statistical improvement in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) in those treated with BTX-B (evaluated as NeuroBloc) compared with placebo. " 09/13/2005 - "To compare autonomic effects of botulinum toxin (BTX), we randomized patients with cervical dystonia to receive either BTX-A or BTX-B in a double-blind manner. " 07/01/2005 - "Botulinum toxin type B (BTX-B) has been approved by the Food and Drug Administration for the treatment of cervical dystonia. " 05/01/2005 - "Botulinum toxin type B (BTX-B, Myobloc, San Francisco, CA, USA) was FDA-approved for the treatment of cervical dystonia in December 2000. "
10.	Trihexyphenidyl (Artane)FDA LinkGeneric 01/01/2005 - "It compared BtA versus trihexyphenidyl in 66 patients with cervical dystonia. " 09/01/1998 - "Electromyography in cervical dystonia: changes after botulinum and trihexyphenidyl." 04/01/1996 - "Mean dose of trihexyphenidyl was 16.25 mg. The changes on the Disability section of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS-Disability) (primary outcome), Tsui Scale, and the General Health Perception Subscale were significantly in favor of BTA. " 12/01/1986 - "Trihexyphenidyl and torticollis." 01/01/2005 - "The available evidence suggests that BtA injections provide more objective and subjective benefit than trihexyphenidyl to patients with cervical dystonia. "

Therapies and Procedures

1.	Deep Brain Stimulation 03/08/2011 - "This study provides Class III evidence that bilateral subthalamic nucleus deep brain stimulation results in significant improvement in cervical dystonia without bradykinetic side effects." 11/01/2002 - "With activation of deep brain stimulation, there was significant improvement of the cervical dystonia, persisting for 12 months of follow up. " 08/01/2015 - "Pallidal deep brain stimulation (DBS) is effective in alleviating motor symptoms of medication refractory cervical dystonia, but little is known about effects on cognitive functions. " 06/01/2014 - "Deep brain stimulation (DBS) of the globus pallidus internus is an effective treatment for cervical dystonia (CD). " 10/01/2010 - "Bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) was shown to be effective in cervical dystonia refractory to medical treatment in several small short-term and 1 long-term follow-up series. "
2.	Injections 11/15/2009 - "A design in which the paramedical intervention is added to a current gold standard, for example, BoNT-A injections in cervical dystonia, is recommended." 01/01/1992 - "Eighty-six injections in 49 patients with adult onset spasmodic torticollis were evaluated for efficacy with respect to single point per muscle versus multiple point per muscle injection techniques. " 05/01/1997 - "To further study possible distant effects of repeated BTX-A injections, we obtained percutaneous muscle biopsies of the vastus lateralis muscle from 11 patients with cervical dystonia. " 12/01/2014 - "Cervical dystonia (CD) patients usually receive repeated botulinum neurotoxin (BoNT) injections. " 10/01/2014 - "Consequently, our objective was to investigate the effectiveness of physiotherapy alone or as an adjuvant treatment to BoNT/A injections in cervical dystonia (CD) by means of a systematic literature review. "
3.	Decompression 08/01/2014 - "Microvascular decompression surgery is effective for the laterocollis subtype of spasmodic torticollis: a long-term follow-up result." 01/01/1998 - "Unilateral microvascular decompression of accessory nerve proved to be effective in homolateral type of torticollis." 05/01/1991 - "The results of treatment of spasmodic torticollis are analysed and the efficacy of neurovascular decompression is emphasized." 01/01/1989 - "We found so far sixteen cases of spasmodic torticollis in the literature including ours who were benefited by microvascular decompression (MVD). " 11/01/1986 - "A case of spasmodic torticollis in a 27-year-old man cured by vascular decompression of the spinal accessory root, without any nerve sectioning, is presented. "
4.	Denervation 07/01/2003 - "When abnormal contraction of LSM is responsible for laterocollis in patients with cervical dystonia, selective peripheral denervation of this muscle is a safe and effective procedure for alleviation of the symptom." 01/01/1999 - "We conclude that selective peripheral denervation of the levator scapulae muscle is safe and effective in the treatment of laterocollic type torticollis." 04/01/2008 - "The purpose of this cadaveric study was to explore a modification to the Bertrand procedure for the treatment of spasmodic torticollis, namely the denervation of the levator scapulae (LS) muscle for laterocollis. " 07/01/2003 - "The purpose of this study is to define the effects of selective peripheral denervation of LSM in patients with laterocollic cervical dystonia.The" 12/01/2015 - "Selective peripheral denervation remains a surgical option in the treatment of cervical dystonia when conservative measures fail. "
5.	Intramuscular Injections 05/01/2014 - "The objective of this study was to estimate the probability of development of partial secondary treatment failure (PSTF) in patients with cervical dystonia (CD) who had been treated over up to 9 years with repetitive intramuscular injections of botulinum neurotoxin type A (BoNT/A). " 09/01/1997 - "Clinically, intramuscular injection of nanogram quantities of BoNT is fast becoming the treatment of choice for a spectrum of disorders including movement disorders such as torticollis, blepharospasm, Meige Disease, and hemifacial spasm (Borodic et al., 1991, 1994a; Jankovic and Brin, 1991; Clarke, 1992). " 12/15/2007 - "Intramuscular injection of botulinum toxin is the first line treatment in cervical dystonia, in axial truncal dystonias botulinum toxin therapy is used only in mild forms. " 01/01/1991 - "In a double-blind, placebo-controlled study, 23 patients suffering from intractable spasmodic torticollis (ST) were given successively either botulinum toxin A (BTA) or normal saline by intramuscular injections in the affected muscles. " 09/01/2015 - "Intramuscular injections of botulinum toxin (BTX) are used as symptomatic treatment for cervical dystonia. "