Atlantoaxial rotatory fixation (AARF) resulting from drug-induced cervical 
dystonia (DICD) represents an extremely rare complication of antipsychotic 
treatment, requiring a comprehensive assessment of pharmacologic therapy and 
timely radiologic workup. We report a chronic case of Fielding type I, Pang type 
I AARF secondary to schizophrenia treatment in a 16-year-old girl, along with a 
review of the literature on the management challenges posed in this condition. 
In this scenario, torticollis may just represent the tip of the iceberg, and 
only an effective multidisciplinary approach increases the chances of 
satisfactory correction with closed reduction, hence avoiding the burden of more 
invasive treatment options.