The differential diagnosis for new onset of neck pain and torticollis during childhood is extensive. It includes benign paroxysmal torticollis, traumatic neck injury, infections, calcification of the cervical disc, congenital abnormalities of the cervical vertebrae such as hemiatlas, Arnold-Chiari malformation, central nervous system tumours, neurogenic or drug-induced dystonias, gastroesophageal reflux with torsional neck spasms (Sandifer syndrome), inflammatory arthritis and myositis. A careful clinical assessment is necessary to differentiate benign causes from more serious causes of neck pain and torticollis.
Benign paroxysmal torticollis is a self-limiting condition that usually presents in children younger than five years of age. It has been described as a migraine equivalent with recurrent episodes of head tilt associated with vomiting, irritability, ataxia and drowsiness. Traumatic injuries may involve the vertebrae, muscles or ligaments, or may result in a spinal epidural hematoma. Unusual or extreme posturing of the neck, gait abnormalities and neurological deficits are concerning for possible posterior fossa tumours, spinal cord tumours, spinal cord compression and discitis. These conditions may also be associated with headaches, night pain, vertigo, visual disturbances and vomiting. A child with a retropharyngeal abscess, cervical adenitis, osteomyelitis or discitis involving the cervical spine may present with fever, neck pain and limited range of motion. Medications and herbal supplements with extrapyramidal side effects may lead to neck pain and torticollis. Finally, ocular motility disorders may also lead to postural torticollis when children tilt their heads to avoid diplopia. All you need to discover how safe and advantageous it can be to purchase generic viagra online cialis professional over the internet is visit the pharmacy suggested and enjoy your shopping experience as well as your treatment.