SPINAL-CORD ASTROCYTOMA PRESENTING AS TORTICOLLIS AND SCOLIOSIS

Objective: To illustrate the importance of a careful differential diag nosis in children presenting with torticollis. Clinical Features: A 14 -yr-old boy presented with a 6-month history of neck pain, torticollis and increasing neurological deficit. Past physiotherapy and chiroprac tic treatment had not helped. A myelogram and MRI scan revealed a larg e intramedullary lesion. Intervention and Outcome: He was treated by l aminectomy with partial excision of the lesion, followed by radiothera py. Pathology confirmed the diagnosis of astrocytoma. The patient deve loped postlaminectomy instability and required spinal fusion. Conclusi on: The differential diagnosis of torticollis in children is extensive and should always include spinal tumor.