Late presentation of congenital muscular torticollis: a non-dystonic cause of torticollis.

We describe three patients with a late presentation of congenital muscular torticollis to emphasize that this non-dystonic type of torticollis has to be considered in the differential diagnosis of cervical dystonia, even in adult patients. Surgery is the treatment of choice. Postoperatively, two of our patients had a transient lesion of the accessory nerve. We assume that in our patients the accessory nerve was embedded in the fibrous tissue around the affected muscle. To prevent damage to the accessory nerve, the incision has to be made distally at about 1 cm above the clavicle.