Objective: The objectives of this report is to survey whether the type of torticollis (i.e. rotation, retrocolis and anterocolis) is related to the clinical characteristics and demographics of icervical dystonia

Background: Among many studies about cervical dystonia, demographics and clinical outcome were unexpectedly not often referred associated with the direction of neck movement. 

Methods: 82 patients with cervical dystonia were treated including botulinum toxin in our botulinus center. They were divided into three groups in terms of the direction of the neck movement/posture; rotation of lateral-flexion (47), retrocolis (8), anterocolis (27) and the clinical and demographic characteristics were reviewed. Clinical outcome was subjectively evaluated based on patient satisfaction.

Results: Onset age is very different among the groups. [Figure 1]. Rotation/Flexion type was asscociated with far younger onset age as well as far better prognosis than anterocolis type [Figure 2]. Anteroclis is frequently presented in parkinsonian patients and often complicated with lordosis. 

Conclusions: The present survey suggests that different direction of the torticolis may represent different clinical entitity.

References: Mov Disord. 2016 Dec;31(12):1874-1882. doi: 10.1002/mds.26817. Epub 2016 Oct 18.Clinical and demographic characteristics related to onset site and spread of cervical dystonia. J Neurol Sci. 2012 Apr 15;315(1-2):100-3. doi: 10.1016/j.jns.2011.11.017. Epub 2011 Nov 30.Clinical subtypes of anterocollis in parkinsonian syndromes.Revuelta GJ1, Benatar M, Freeman A, Wichmann T, Jinnah HA, DeLong MR, Factor SA.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-and-demographics-of-cervical-dystonia-related-to-the-direction-of-the-neck-movement/