Spastic torticollis should be differentiated from the following diseases:
1. Upper cervical lesions: patients with costal pain and cervical disc herniation. Often complain about muscle atrophy in one side of the neck. The head can be tilted, but there will be no spasms. At the same time, all the above lesions can have sensory movement and reflex changes of upper limbs, but spastic torticollis has no effect on upper limb function.
2. Lesions at the craniocervical junction: If the craniocervical junction is severely deformed, such patients often have symptoms of nerve compression at the craniocervical junction, such as unstable walking, dysphagia, decreased muscle strength of limbs, increased muscle tension, and low hairline after neck thickening, such as syringomyelia, segmental pain, and tactile separation of upper limb muscles. Similarly, the patient may have torticollis, but there will be no spasm.
3. Congenital unilateral sternocleidomastoid muscular atrophy: more common in children, more common in birth injuries, contralateral muscle atrophy, compensatory hypertrophy of the healthy side, but no spasm.
4. Posterior cranial myalgia in children: In order to relieve the pain, the patient forced the head position to cause some muscles in the neck to be stiff. Although there is a head tilt posture, it will not have a seizure. At the same time, all patients have obvious posterior cranial symptoms, such as headache, vomiting, unsteady walking, nystagmus, etc. Children with short medical history should also be differentiated from ocular torticollis. Because one eye is sick, most of them are partial ocular muscle paralysis, and the head of the sick child is inclined when looking at the object.
5. Finally, it should be differentiated from hysterical torticollis. All patients have clear mental factors. Suddenly, the symptoms change irregularly, and the symptoms disappear quickly after emotional stability.