I Hope Someone Can Help

[saskas]

I have a 13yr old daughter who woke up one morning in Sept. '07 with neck pain and unable to turn her neck to the right.  Her neck/head also was tilted to the left. PCP stated that it was Torticollis and that it should go away in a couple of days.  After not resolving he prescibed a muscle rexlant which did not help. Soft cervical collar was also tried, did not help.  Sent for physical therapy, did not help, and probably made worse. PT stated that there must be an underlying condition because she could not get anywhere in helping her.  Went to orthopedic who was concerned with possible atlantoaxial subluxation and sent her to a pedi ortho.  He ordered a CT scan and said that everthing was fine.  He put her on vallium, which do not help any.  Then told her PCP he didn't know what was wrong with her so he was sending her back to her.  My main question is: Can atlantoaxial subluxation be diagnosed without a functional CT.  The CT she had only took a minute and she did not have to rotate her head at all.  Here it is 2/08 and she can still not turn her head to the right.  She has severe muscle spasm.  She also has two large knots on both the right/left top of her back.  She is in constant pain. The Physical therapist finds that he shoulder blades are not aligned.  One shoulder blade sticks out much more that the other.  One shoulder is higher than the other.  Collarbone protrudes on one side and is painful if touched.  Neck is painful if touched on either the right or left side (more on right).  Can not rotate to right.  She said that she is very asymmetrical.  She did have a MRI of the cervical spine and one of the brain.  However, they were undiagnostic or very limited to to distortion from dental braces.  Does anyone have any suggestions?  I really need some help!

[darlingdivatx]

From what little I know about torticollis it's sometimes treated with botox with great success. Also if this is of a neurologic etiology then some of the drugs the docs have tried so far may be making it worse. I say see a neurologist asap!!

[JainMD]

Hi,
Atlanto-axial dislocation can be diagnosed without a functional CT, but has to be confirmed with functional CT only.
I think you need to consult Musculo-skeletal specialist for further evaluation.
A limitation of motion of the cervical spine that causes the head to be held in a tilted position is called as Torticollis.
It may result from muscular, skeletal, or neurologic abnormalities.
Acquired torticollis which she has may result from neurogenic, traumatic, inflammatory, or idiopathic causes.
She needs to be evaluated by a neurologist for neurogenic causes like Spinal cord tumors of the cervical spine, Cerebellar tumors, Syringomyelia, and Ocular dysfunction.
Keep me informed if you have any queries.
Bye.