Neck muscle contracts, causing the head to twist to one side. Choose the following option.

NORCET 1 - 2020

Medical Surgical Nursing

Easy

Appeared in: NORCET 1 - 2020

Explanation

Torticollis, also known as wryneck, is the specific medical term for a condition where the head becomes persistently twisted to one side.
It is caused by the involuntary and sustained contraction of neck muscles, primarily the sternocleidomastoid muscle.
This condition is a form of focal dystonia, which can be an acute extrapyramidal side effect of medications, particularly antipsychotics.

Option B: Oculogyric crisis involves the muscles of the eyes, not the neck. It is characterized by a prolonged, involuntary upward deviation of the eyeballs.
Option C: Tardive dyskinesia involves repetitive, involuntary movements, most commonly affecting the face, mouth, and tongue (e.g., lip-smacking, grimacing, tongue protrusion). It is a late-onset side effect, developing after long-term medication use.
Option D: Pseudoparkinsonism is a drug-induced syndrome that mimics Parkinson's disease. Its key features are resting tremor, muscle rigidity, bradykinesia (slowness of movement), and a shuffling gait, not an acute twisting of the neck.

Visual 1: Illustration - A diagram showing the anatomy of the neck with the sternocleidomastoid muscle highlighted, demonstrating how its contraction leads to the characteristic head tilt and chin rotation of torticollis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of Extrapyramidal Symptoms (EPS) as background academic context rather than a clinical decision trigger.
Recognizing acute dystonic reactions like torticollis and oculogyric crisis is a critical nursing responsibility. These are medical emergencies that are often painful and frightening for the patient.
Prompt intervention is required. The nurse should anticipate orders for and administer anticholinergic medications (e.g., benztropine) or antihistamines (e.g., diphenhydramine), which rapidly reverse the symptoms.
Patient education is key. If a patient is starting a medication known to cause EPS, they should be taught to report any muscle stiffness, spasms, or unusual movements immediately.

How to Approach the Question

This is a recall-based question that tests your knowledge of medical terminology for specific symptoms.
First, identify the core clinical sign described in the stem: a contracted neck muscle causing the head to twist.
Next, analyze the options provided. All are neurological conditions, often related to medication side effects.
Break down the term 'Torticollis': 'Torti-' means twisted, and '-collis' refers to the neck. This directly matches the description.
Differentiate this from the other options by recalling their primary affected areas: Oculogyric (eyes), Dyskinesia (often face/mouth), and Parkinsonism (generalized movement/tremor).

Concept Tested & Keywords

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