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James K. Bredenkamp, MD; Dennis R. Maceri, MD

Arch Otolaryngol Head Neck Surg. 1990;116(3):310-313.

Abstract
• Acute torticollis is commonly seen in the pediatric emergency department. It often results from an inflammatory process that irritates the cervical muscles, nerves, or vertebrae. Posturing of the head occurs with unilateral spasm of the sternocleidomastoid muscle such that the child will position the head with the occiput rotated to the affected side and the chin rotated to the contralateral side. We recently treated 26 children who presented to the emergency department with acute nontraumatic torticollis. The most common causes were upper respiratory infection, sinusitis, otomastoiditis, cervical adenitis, and retropharyngeal abscess or cellulitis. Four patients had subluxation of the atlantoaxial joint as a result of the inflammatory process. Children with acute torticollis need careful evaluation for either overt or occult otolaryngologic infections. Computed tomography and magnetic resonance imaging are helpful in determining the cause of the acute torticollis and in ruling out rotatory subluxation of the atlantoaxial joint.

(Arch Otolaryngol Head Neck Surg. 1990;116:310-313)

Author Affiliations
From the Departments of Otolaryngology-Head and Neck Surgery, UCLA School of Medicine (Dr Bredenkamp) and University of Southern California School of Medicine (Dr Maceri), Los Angeles.

Footnotes
Accepted for publication June 7, 1989.

Presented in part at the annual meeting of the Southern California Chapter of the American College of Surgeons, Palm Springs, Calif, January 28, 1989.

Reprint requests to Department of Otolaryngology-Head and Neck Surgery, University of Southern California School of Medicine, 1200 N State St, Box 795, Los Angeles, CA 90033 (Dr Maceri).

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