RT Journal Article SR Electronic T1 Spasmodic Torticollis: A Case Report and Review of Therapies JF The Journal of the American Board of Family Practice JO J Am Board Fam Med FD American Board of Family Medicine SP 435 OP 441 DO 10.3122/jabfm.9.6.435 VO 9 IS 6 A1 David L. Smith A1 Maria C. DeMario YR 1996 UL http://www.jabfm.org/content/9/6/435.abstract AB Background: Spasmodic torticollis is a movement disorder of the nuchal muscles, characterized by tremor or by tonic posturing of the head in a rotated, twisted, or abnormally flexed or extended position or some combination of these positions. The abnormal posturing of the head allows this disorder to be clinically diagnosed. Psychiatric symptoms frequently accompany or precede the diagnosis of the movement disorder. Methods: Using the key words “torticollis,” “spasmodic torticollis,” “therapy,” “behavior therapy,” “botulinum toxin,” MEDLINE was searched from 1989 to 1996 for information on the cause and treatment of spasmodic torticollis. Results and Conclusions: Therapies include behavior modification, such as biofeedback, hypnosis, or simply training the patient to consciously readjust the position of the head; pharmacotherapy, using a variety of agents, the most commonly prescribed being anticholinergic medications or the botulinum toxin type A; and surgery, which entails selectively denervating the muscles responsible for the abnormal movement or posture of the head. The most effective treatments include surgery and botulinum, with sustained success rates ranging from approximately 60 to 90 percent.