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The clinical course of spasmodic torticollis

From the Department of Neurology, School of Medicine, University of California, San Francisco, CA.

Among 24 of 36 patients with idiopathic spasmodic torticollis referred to one of us over a 10-year period, who were followed up for more than 1 year, we defined three outcome groups. Three patients (13%) underwent complete or almost complete remission at a median of 3. 0 years into the illness. Eight patients (33%) had partial remissions, which tended to occur somewhat later than the first group. The remaining 13 patients had no significant improvement in their disease; they were more likely to be older at the onset of the illness, develop constant rather than intermittent neck deviation, and have a "geste antagonistique." As a whole, the study population was exposed to a wide variety of therapeutic interventions that had little, if any, obvious clinical effect.

Address correspondence and reprint requests to Dr. Lowenstein, Room 794-M, Department of Neurology, School of Medicine, University of California, San Francisco, CA 94143.

Received August 14, 1986. Accepted for publication in final form July 27, 1987.

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