Case history
Case history #1
A 52-year-old woman presents with a history of several months' duration of involuntary spasms in her neck. She relates intermittently feeling the muscles in her neck tighten painfully. The episodes cause her head to turn slightly to the right. She has difficulty looking over her left shoulder when the muscle spasm occurs, which is particularly bothersome while driving. She has symptoms daily, and notes that symptoms are worse late in the day. They are exacerbated by fatigue and emotional stress. She can partially relieve symptoms by placing her hand on her chin during the spasms.
Case history #2
A 49-year-old man presents with a 1-year history of worsening head tremor. The tremor began insidiously and in the past few months has become bothersome to him socially. His colleagues at work frequently make comments about his head movement, and he feels that it is distracting to clients. The incidents negatively affect his performance at work. He denies significant tremor in his hands or voice. He relates that his head "wants to turn more to the right than to the left."
Other presentations
Patients may present with a chief complaint of neck pain or neck spasms without head movement or head tremor.[1]
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