Evaluation of a child with<unk>  begins with history taking to determine circumstances surrounding birth and any possibility of trauma or associated symptoms. Physical examination reveals decreased rotation and bending to the side opposite from the affected muscle. Some say that congenital cases more often involve the right side, but there is not complete agreement about this in published studies. Evaluation should include a thorough neurologic examination, and the possibility of associated conditions such as developmental dysplasia of the hip and clubfoot should be examined. Radiographs of the cervical spine should be obtained to rule out obvious bony abnormality, and MRI should be considered if there is concern about structural problems or other conditions. Ultrasonography can be used to visualize muscle tissue, with a colour histogram generated to determine cross-sectional area and thickness of the muscle. Evaluation by an optometrist or an ophthalmologist should be considered in children to ensure that the<unk>  is not caused by vision problems (IV cranial nerve palsy, nystagmus-associated "null position," etc.). Differential diagnosis for<unk>  includes * Cranial nerve IV palsy * Spasmus nutans * Sandifer syndrome * Myasthenia gravis * Cerebrospinal fluid leak Cervical dystonia appearing in adulthood has been believed to be idiopathic in nature, as specific imaging techniques most often find no specific cause.
Torticollis
Spasmodic torticollis
Equinovalgus
Abulia
Pseudostrabismus
Dysbarism
Strabismus
Diplegia