Algorithm for torticollis diagnosis in children of younger age groups

BACKGROUND: Torticollis is a common term for abnormal head or neck positions. Torticollis can be due to a wide variety of pathological processes, from relatively benign to life-threatening. This syndrome is of particular relevance in pediatric practice and is often underestimated at the primary care level. AIM: To analyze the data of domestic and foreign literature on the etiopathogenesis and clinical features of various types of torticollis in children and develop algorithms for the differential diagnosis of torticollis in children of younger age groups. MATERIALS AND METHODS: A literature search was conducted in the open information databases of eLIBRARY and Pubmed using the keywords and phrases: torticollis, congenital muscular torticollis, non-muscular torticollis, acquired torticollis, and neurogenic torticollis, without limiting the depth of retrospection. RESULTS: Based on the literature data generalization, the classification of torticollis and the key directions of its differential diagnosis are systematized in tabular form. The range of differential diagnosis of torticollis is quite wide and has its characteristics in newborns and children of the first years of life, contrary to older children. The most common is congenital muscular torticollis. Concurrently, non-muscular forms of torticollis in the aggregate are not uncommon, more often with a more serious etiology, and require careful examination. Based on the analyzed literature, differential algorithms for torticollis diagnosis in children of younger age groups have been compiled. CONCLUSIONS: Increasing the level of the knowledge of pediatric clinicians in the etiopathogenesis of torticollis syndrome will improve the efficiency of early diagnosis of dangerous diseases that lead to pathological head and neck positions in children.

Congenital muscular torticollis: an Orl’s perspective

<p>Congenital muscular torticollis usually results from the shortening or excessive contraction of sternocleidomastoid muscle. Delay in diagnosis and appropriate early therapeutic evaluation can lead to permanent disability. We would like to report two rare cases with congenital muscular torticollis who underwent surgery followed by aggressive physiotherapy. We would like to emphasise the need of an early diagnosis and intervention which leads to best outcome. This can prevent progressive physical deformity. Surgeons should offer the patient with option of release and repair of sternocleidomastoid muscle as it gives excellent result in view of mobility and appearance for child.</p>

Fifteen-minute consultation: Evaluation of paediatric torticollis

Torticollis refers to a state in which the neck is twisted due to excessive contraction or shortening of the muscles on one side. Congenital muscular torticollis, which is more common than acquired torticollis, has an incidence of 0.3%–1.9% among all live births. The clinical approach to torticollis depends on the age at presentation, duration of torticollis and presenting symptoms. The underlying aetiology for torticollis varies with the age of the child. Torticollis can be a presenting feature for life-threatening conditions and thus requires careful evaluation.

Effectiveness of hydrotherapy in congenital muscular torticollis

Congenital muscular torticollis (CMT); is one of the musculoskeletal diseases seen in the neonatal and infant period. It is formed as a result of stretching the sternocleidomastoid (SCM) muscle in childhood. Due to unilateral contraction of the SCM muscle, ipsilateral head tilt, contralateral face and jaw rotation occur. Exercise and positioning in physical therapy constitute the conservative treatment of CMT. Hydrotherapy treatment has not been used in CMT cases. However, most of the CMT which are not treated early are resolved by surgical intervention. In this case, the effectiveness and success of exercise and hydrotherapy on the patient with CMT were presented.

Is Longstanding Congenital Muscular Torticollis Provoking Pelvic Malalignment Syndrome?

It has been reported that congenital muscular torticollis (CMT) may result in secondary scoliosis over long-term follow-ups. However, there are few reports on whether CMT causes pelvic malalignment syndrome (PMS). This study aimed to investigate the relationship between CMT and PMS and to determine the factors associated with the development of PMS in children with longstanding CMT. Medical records of 130 children with CMT who had long-term follow-up were reviewed retrospectively. The chi-squared test and logistic regression analysis were used to determine which initial clinical parameters contributed to the development of PMS. Among 130 children with CMT, 51 (39.2%) developed PMS with or without compensatory scoliosis during long-term follow-up, indicating a high prevalence of PMS in children with a CMT history. Initial clinical symptoms such as a limited range of motion of the neck or the presence of a neck mass could not predict the development of PMS. Even if the clinical symptoms are mild, long-term follow-up of children with CMT is essential to screen for PMS.