Musculoskletal

1. Congenital

Bony

Structural abnormalities of the cervical upper thoracic spines

Clark 1976

Soft tissue

Congenital shortening of the sternomastoid

or intrauterine deformation. The latter usually resolves spontaneously

Sarnat and Morrisy 1981; Suchowersky and Calne 1988

2. Acquired

Subluxation/ dislocation/ fracture

Subluxation most frequently involves C1–C2 or C2–C3. Sometimes rotatory & may be spontaneous or traumatic.

Suchowersky and Calne 1988

Infection

Osteomyelitis or soft tissue inflammation in the neck (ie lymphadenitis retropharyngeal abcess etc), associated with pain.

Korngold 1959

Arthritis

Especially osteoarthritis ankylosing spondylitis and rheumatoid arthritis.

Neoplasm

Tumour involving bone or soft tissues.

Hiatus hernia

‘Sandifer's syndrome’ Posturing in infancy of neck due to oesophogeal discomfort

Kinsbourne 1964; Murphy and Gellis 1977; Sutcliffe 1969

Neurological

Ocular

Compensates oblique diplopia

Also seen in congenital nystagmus and spasms nutans (ie nystagmus, head nodding & torticollis).

Troupe 1978; Spillman 1981; Klatzman et al. 1981; Walsh and Hoyte 1969

Vestibular

Compensates for disturbed vestibular function. Doubtful if chronic tilt develops in adults.

Tarlov 1970

Intracranial mass especially posterior fossa

Winther 1930: Boisen 1979

Benign paroxysmal torticollis in infancy.

Recurrent head tilt pallor, vomiting, aggitation? vestibular? vertebrobasilar

Snyder 1969; Deonna and Martin 1981

Intraspinal pathology

Uncommon. Spinal cord tumour or syrinx

Kiwak et al. 1983

Basal ganglia lesions

Infarction

Molho and Factor 1993

Arteriovenous malformation

Usually involving basal ganglia

Chapter 43, Lobo–Antunes et al. 1974

Trauma

Isaac and Cohen 1989

Tumour

Schulze-Bonhage and Ferbert 1995

Drug induced dystonia

Chapter 43

Infectious

Encephalitis lethargica

Chapter 12; Patterson and Little 1943; L’ hermitte and Levy 1929; Hassin et al. 1931

Syphilis

Shaeffer and Bize 1934

Malaria

Mechanism uncertain

Finney and Hughson 1925; Meares 1973

Acute infective torticollis

Uncertain entity

Chapter 43; Neng et al. 1983

Immune-mediated

Rheumatic fever

Doubtful

Curling 1860

Inflammatory

Multiple sclerosis

Rare

Guillain and Bize 1933

Metabolic

Hyperthyroidism

Relationship uncertain

Gilbert 1972, Stern 1902,

Epilepsy (versive attacks)

May occur alone or be associated with other epileptic manifestations

Chapter 50

Colloid cyst of third ventricle

Rare

Avman and Arasil 1969

Tics

see text under ‘Pathophysiological

Mechanisms’

Hysteria

see text under ‘Pathophysiological Mechanisms’