Pseudodystonic Emergencies

  • Jong-Min Kim
  • Beom S. JeonEmail author
Part of the Current Clinical Neurology book series (CCNEU)


Dystonia is a syndrome of sustained muscle contractions, causing ­abnormal postures, twisting, and repetitive movements. Dystonic appearance may be mimicked by other neurological diseases in which sustained abnormal postures may be present, but which are not considered a true dystonia, and hence are called pseudodystonia. Some forms of pseudodystonia are neurological emergencies, requiring urgent evaluation and treatment. Atlanto-axial subluxation, infectious torticollis, and tetanus all require appropriate measures; otherwise they will result in medical disasters. In this chapter, we discuss causes, evaluation, and management of pseudodystonic emergencies.


Down Syndrome Juvenile Rheumatoid Arthritis Acute Rheumatic Fever Head Tilt Sustained Muscle Contraction 

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  1. 1.
    Fahn S. Concept and classification of dystonia. Adv Neurol. 1988;50:1–8.PubMedGoogle Scholar
  2. 2.
  3. 3.
    Uziel Y, Rathaus V, Pomeranz A, Solan H, Wolach B. Torticollis as the sole initial presenting sign of systemic onset juvenile rheumatoid arthritis. J Rheumatol. 1998;25:166–8.PubMedGoogle Scholar
  4. 4.
    Merello M, Garcia H, Nogues M, Leiguarda R. Masticatory muscle spasm in a non-Japanese patient with Satoyoshi syndrome successfully treated with botulinum toxin. Mov Disord. 1994;9:104–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Grogaard B, Dullerud R, Magnaes B. Acute torticollis in children due to atlanto-axial rotary fixation. Arch Orthop Trauma Surg. 1993;112:185–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Fiorillo L, Robinson JL. Localized tetanus in a child. Ann Emerg Med. 1999;33:460–3.PubMedCrossRefGoogle Scholar
  7. 7.
    Shafrir Y, Kaufman BA. Quadriplegia after chiropractic manipulation in an infant with congenital torticollis caused by a spinal cord astrocytoma. J Pediatr. 1992;120:266–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Berry DS, Moriarty RA. Atlantoaxial subluxation related to pharyngitis: Grisel’s syndrome. Clin Pediatr. 1999;38:673–5.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of NeurologySeoul National University HospitalSeoulKorea

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