They were categorized as torticollis, laterocollis, anterocollis, retrocollis, and combined form according to their clinical manifestation.
83%, of the 17 patients with combined form, 11 had torticollis in addition to retrocollis, 4 had torticollis in addition to anterocollis, and 2 had multiple-sided rotation) of the patients.
Any of the 52 muscles in the neck can be involved in combination to produce involuntary movements in a sustained or spasmodic nature in a combination of anterocollis, laterocollis, rotational torticollis or retrocollis
Clinical manifestations of acute bilirubin encephalopathy and kernicterus * Condition Phase Clinical manifestations Acute bilirubin Early Lethargy encephalopathy Hypotonia Poor suck Intermediate Moderate stupor Irritability Hypertonia manifested by backward arching of the neck (retrocollis
) and trunk (opisthotonos) Fever and high-pitched cry, which may alternate with drowsiness and hypotonia Advanced Pronounced retrocollis
and opisthotonos Shrill cry No feeding Apnea Fever Deep stupor to coma Sometimes seizures and death Kernicterus NA Athetoid cerebral palsy Auditory dysfunction Dental-enamel dysplasia Paralysis of upward gaze Some or all of the signs listed in the advanced phase of bilirubin encephalopathy * From 2004 clinical guidelines (reference 4).
Typically they will have a retrocollis
or torticollis of the neck; tightening of the muscles in the shoulder girdle; or other sustained muscle postures of the neck, trunk, face, or axial muscles.