title: Torticollis as the only manifestation of acute disseminated encephalomyelitis.
abstract: Torticollis can be either congenital or acquired. Acquired torticollis is often the manifestation of an underlying central nervous system disorder. Acute painless torticollis should always raise suspicion of a posterior fossa tumor. Acute disseminated encephalomyelitis is an inflammatory demyelinating disease of the central nervous system involving the subcortical white matter, and to a lesser extent, the gray matter. The illness typically has a monophasic course characterized by a variable combination of fever, headache, meningismus, seizures, spasticity, cranial nerve palsies, ataxia, and psychosis. The course, although often clinically severe, is generally benign with most children making a full recovery. A toddler presenting with subacute painless torticollis as the only manifestation of acute disseminated encephalomyelitis is described. The authors believe the neck twist in this child represented a form of dystonia because of basal ganglia involvement. Torticollis has not been reported as a presenting or only sign of disseminated encephalomyelitis.
authors.affiliation: Child Neurology Unit, Meir Medical Center, Tel Aviv University, Kfar Saba, Israel.
authors.forename: Miki
authors.initials: M
authors.lastname: Har-Gil
authors.forename: Merav
authors.initials: M
authors.lastname: Evrani
authors.forename: Nathan
authors.initials: N
authors.lastname: Watemberg
mesh_terms: D002675:Child, Preschool; D004673:Encephalomyelitis, Acute Disseminated / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012075:Remission, Spontaneous; D014103:Torticollis / Q000175:diagnosis / Q000209:etiology*