Microvascular decompression with partial occipital condylectomy in a case of pediatric spasmodic torticollis


Spasmodic torticollis is a rare, neurologic disorder that is caused by abnormal nerve compression of the 11th cranial nerve by blood vessels or bony protrusions. It is typically treated pharmacologically and, if necessary, with surgical intervention. We report a unique case of spasmodic torticollis in a 15-year-old female that involved abnormal compression of the left 11th cranial nerve (CN) by the left vertebral artery, displaced by a hypertrophic left occipital condyle. After treatment with Botox was unsuccessful, the patient was treated with microvascular decompression and occipital condylectomy that adequately relieved the abnormal compression of CN XI. Mild symptoms persisted, and the patient underwent a partial section of the sternocleidomastoid muscle 1 year later, after which torticollis symptoms resolved.

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We acknowledge the research and editing support of Superior Medical Experts for this manuscript.


We received a grant from the United Hospital Foundation in support of this work.

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Correspondence to Eric S. Nussbaum.

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Graupman, P., Feyma, T., Sorenson, T. et al. Microvascular decompression with partial occipital condylectomy in a case of pediatric spasmodic torticollis. Childs Nerv Syst 35, 1263–1266 (2019). https://doi.org/10.1007/s00381-019-04065-8

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  • Spasmodic torticollis
  • Torticollis
  • Microvascular decompression
  • Accessory nerve