Congenital Torticollis
Congenital torticollis occur at birth and if felt to be related to the babies position in the womb or trauma at the time of birth. Some schools of thought feel the condition occurs in utero and is the cause of a difficult birth rather than the birth causing the condition. Breech birth presentations have been found to have a higher incidence of torticollis. Torticollis is also often associated with plagiocephaly which is a flattening of the infants head from holding her head against the mattress in the same position due to the shortened neck muscles not allowing easy turning of the head. About twenty percent of babies with torticollis also have hip dysplasia and a complete workup will include checking your baby for this problem as well.
The symptoms of congenital torticollis may appear from birth up to two months after birth. The symptoms consist of one or more muscles of the neck being shortened and the neck being twisted to one side or the other and unable to turn. There is usually a fibrous mass of tissue impeding movement of the muscle on the affected side. You may be able to feel this mass when pressing on the affected side. Left untreated congenital torticollis can cause facial deformity and asymmetry in the developing infant.
Congenital torticollis is a reversible condition if it is caught early. Diagnosis is based on history and physical exam. Often the parent is the first to notice their child head is always turned to one side. The condition is generally muscular in origin but can occasionally be due to a boney deformity of the spine.
Treatment of congenital torticollis involves physical therapy to stretch the shortened muscles of the baby’s neck. The parents will be taught exercises to do at home to support physical therapies affect. If torticollis is caught early eight to ninety percent of babies with the condition can be helped with conservative treatments such as physical therapy.
If congenital torticollis does not respond to conservative treatment, surgery may be needed to correct the condition. Surgery involves cutting the fibrous non cancerous band holding the sternocleidomastoid muscles as well as cutting and reattaching the shortened muscle to allow full range of motion. If a boney deformity is involved different techniques will be used to correct the problem. Surgery is generally very successful in correcting the problem when it has not responded to more conservative methods of treatment.
Congenital torticollis is a fairly common problem that responds well to conservative treatment when caught early and surgical intervention has high success rates when surgery is needed.
Sources:
<http://www.e-neurosurgery.ws/cnsclinicjordan/congenitaltorticollis.htm>
<http://www.healthofchildren.com/U-Z/Wryneck.html>
Disclaimer:
This article is informational and not medical advice. Always follow up with your doctor for any questions regarding your health care.
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