Ocular Torticollis

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The term “ocular torticollis” was applied by Cuignet in 1874 to a compensatory tilting of the head in cases of paralysis of one of the muscles controlling the vertical movements of the eye. The patient unconsciously assumes this position to avoid diplopia.

The following case is presented to show the need for eye muscle studies in all cases of torticollis.

Case Report

A 57-year-old woman reported to Cleveland Clinic in October, 1944, with the complaint of “sore neck” and “spasm of neck muscles”. She stated that for twelve years she had had a “drawing” of the neck, which had noticeably increased during the past two years. Examination revealed the head (chin) turned to the left, the patient having difficulty straightening her head.

There was decided apparent hypertrophy of the right sternomastoid muscle. X-ray examination of the cervical region of the spine showed a slight cervical dorsal scoliosis of the cervical and dorsal regions of the spine. Considerable osteoarthritis was present in the cervical area, and there was some calcification of the intervertebral discs.

The intervertebral spaces were narrowed below the level of the fifth cervical vertebra. The impression was osteoarthritis of spine, cervical region. Laboratory reports showed blood Wasserman and Kahn tests negative, other reports within normal limits. Blood pressure was 135/85; heart and lungs were normal.

It was believed that the patient had a spasmodic torticollis, and she was placed on physiotherapy, from which she received partial relief.

On February 27, 1946, she returned to the Clinic with symptoms. . .



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