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Warning-sign checks

Spasmodic torticollis: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services for sudden facial drooping, arm or leg weakness, severe loss of balance, difficulty speaking, or a sudden severe headache.

    These can be signs of a stroke or another emergency rather than cervical dystonia.

    A new abnormal neck position after a significant injury, especially with weakness, numbness, severe pain, or loss of bladder or bowel control, also needs emergency assessment.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact your treatment team promptly if symptoms change significantly, injections provide much less benefit than expected, or you develop troublesome neck weakness or swallowing difficulty after treatment.

    Seek urgent medical help if you cannot swallow fluids, are repeatedly choking, or develop breathing difficulty, particularly after botulinum toxin treatment.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange a routine medical appointment if you develop repeated or persistent neck pulling, involuntary head turning, or an unexplained head tremor.

    Gradual symptoms still deserve assessment, especially when they cause pain or interfere with daily activities.

Every sign above is quoted from the sofidex article on Spasmodic torticollis. If you are not sure, err upward — it is always reasonable to be checked.