Congenital torticollis

Proven content

Congenital torticollis is keeping the head tilted sideways towards one shoulder while turning the face to the opposite (healthy) side. The head is tilted both in the standing and lying position. The underlying problem is the shortening of the sternocleidomastoid muscle due to its fibrosis.

What is Congenital Torticollis?

Congenital torticollis is a condition in which the head tilts when standing, sitting or lying down. Tilting your head to the side is painful. In the case of the left torticollis, the neck is bent to the left, while in the case of the right-hand torticollis, it is bent to the right. As a result of this ailment, there is an increased tension of the muscle on one side of the neck and the simultaneous weakening and tightening of the same muscle on the other side. The cause of congenital torticollis is a defect of the sternocleidomastoid muscle on one side of the body due to its scarring and fibrosis. It can appear at an early stage of development or as a result of a perinatal trauma. Another cause of torticollis is primary changes in the skeletal system. Acquired torticollis also occurs in vision and hearing defects, spastic increased tension in the neck muscles, as well as in inflammatory and post-traumatic lesions and systemic diseases.

As the disease progresses, the face also changes. Half of the face on the side of the shortened muscle grows more slowly, which causes the face to lose its symmetry. The skeleton and skull are also deformed, and an incorrect bite is formed. Also, the cervical vertebrae undergo deformation and deformation over time.

Types and causes of torticollis

1. Congenital torticollis – the most common cause of its formation is the perinatal trauma in the neck area, which occurs when the child passes through the woman’s genital tract. The cause of muscular torticollis may also be the wrong position of the baby’s head in the womb. On the other hand, torticollis of bone origin may arise as a result of certain malformations in the skeleton or in the course of Klippel-Geil disease, which is characterized by changes in the structure of the vertebrae.

2. Acquired torticollis – This form, unlike congenital torticollis, is usually a consequence of inflammatory conditions that include: tonsils, lymph nodes in the neck, mastoid, and abscesses. It also appears in the course of discopathy and rheumatic diseases. In some people, the acquired form of this condition is associated with a herniated intervertebral disc or sudden neck movements and poor posture, such as incorrect head position during sleep. Other causes are: nervous disorders, vision or hearing impairment, damage to the cervical vertebrae and cancer.

Congenital torticollis – symptoms

A characteristic symptom of congenital torticollis is, of course, the tilt of the head to the side and twisting it in the opposite direction, looking slightly upwards. This is accompanied by:

1. neck pain,
2. neck stiffness
3. Headache,
4. head cannot be moved freely,
5. swollen muscles in the neck.

In children in the course of congenital torticollis, one arm may additionally be lifted towards the contracted neck muscles. The deformity worsens with the development of ailments. In addition, it is worth mentioning that the face on the contracted side is smaller and the nose tilts towards the affected side. The angles of the eyes and ears are also lowered, making the eye appear much smaller and have a different shape. Sometimes an abnormal bite and deformation of the skull may occur, while in the cervical spine – scoliosis develops, the arch of which is directed towards the healthy side of the body.

Diagnosis and treatment of congenital torticollis

The following tests are used to diagnose spasmodic torticollis:

1. EMG (electromyogram) – a test performed to measure the electrical activity in muscles; helps to identify which muscles have been affected;
2. RTG;
3. magnetic resonance imaging.

Treatment of congenital torticollis should be started as early as possible – from the first days after birth, under the supervision of an orthopedist. It is a conservative treatment. On the other hand, surgical treatment is used after the age of 1. It is applied when the exercises to stretch the neck muscles have no effect. Then the neck muscles are lengthened, the pathological vertebrae are surgically fused and the nerves or muscles are cut. The other treatments are:

1. massages,
2. applying warm compresses,
3. laser therapy or irradiation with the Sollux lamp,
4. the use of neck braces,
5. using a rail,
6. kinesiotaping (applying special tapes to relax and strengthen specific muscles; a method that has recently become very popular).

Pharmacological treatment of hereditary torticollis involves the use of muscle relaxants, painkillers, preparations for treating tremors in Parkinson’s disease and botulinum toxin.

Practical advice for parents of children with congenital torticollis:

1. when putting the child to sleep, lay him on his back with his head placed between, for example, bags, thanks to which the collarbones are stabilized and it is impossible to lift the shoulders;
2. the child should turn his head towards the cramped muscle, so when you set up his crib, remember to place it as close to the light as possible, so that it attracts the child’s attention; you can also hang toys over a pram or crib;
3. always feed the breast or bottle on the side of the muscle when feeding.

What should a child with congenital torticollis avoid?

1. the child should not lie with a pillow under his head,
2. should not lie on the stomach with a roller under the chest and the head tilted back,
3. the child should not sit up with pillows,
4. do not carry the baby with the head in a vertical position; it is best when we place it on the side opposite to the torticollis and rest its head on the forearm of the person wearing it.

The content of the medTvoiLokony website is intended to improve, not replace, the contact between the Website User and their doctor. The website is intended for informational and educational purposes only. Before following the specialist knowledge, in particular medical advice, contained on our Website, you must consult a doctor. The Administrator does not bear any consequences resulting from the use of information contained on the Website.