Torticaput versus Torticollis: Clinical Effects with Modified Classification and Muscle Selection

Abstract

Background: Several different subtypes are distinguished in cervical dystonia, depending on their different levels of movement. In simple rotation, classified as torticollis spasmodicus, we now differentiate between torticollis and torticaput dependent on whether only the head or the neck is turned. The new classification system permits for different injection schemes. Case reports: In a retrospective study of 22 patients, we examined whether modifying the injected muscles leads to improvement in the results as evaluated in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). The results showed that both injection schemes do in fact lead to improvements while differentiating between caput and collum has significantly better effects. Discussion: Due to our results we recommend the classification differentiating between torticollis and torticaput type.

Keywords

• Torticaput
• torticollis
• cervical dystonia
• botulinum toxin
• TWSTRS
• Obliquus capitis inferior
• sonography