Although the term spasmodic torticollis is used to describe cervical dystonia, the word torticollis actually refers to any abnormal twisting of the neck. The words “torticollis” does not necessarily mean “dystonia.”
Torticollis that occurs very early in life (usually within the first few weeks) is not a true dystonia. This condition is called infant torticollis, and there are many different reasons why a baby may have torticollis. The most common form of torticollis in infants is congenital torticollis. Congenital torticollis usually improves with physical therapy; however, surgery may be needed.
A toddler who develops torticollis or an irregular neck posture may be affected by a host of conditions including hiatal hernia (with vomiting, feeding problems, and posturing of neck during feeding), double vision (producing head tilt), lack of oxygen or high bilirubin counts during the perinatal period (producing cerebral palsy), severe brain infection (encephalitis), head or neck trauma, toxin exposure, brain or spinal tumors or vascular malformations, specific kinds of brain cysts, and certain chemical disorders, such as Leigh's disease. These conditions may generally be assessed with brain and neck imaging and blood and urine analysis.
Cervical dystonia that affects adults usually occurs after age 30. Children who develop true dystonia rarely begin with symptoms in the neck.