Torticollis in Infants: Causes, Symptoms and Treatment

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2011

Torticollis means ‘twisted neck ‘. Torticollis leads to the tilting of the head. If the babies have this condition their head will be tilted to one side while the chin tilts to the other side. It is also called ‘wry neck’.

So what causes lead to this? Is it can be treated? The reasons for this are many but the condition is treatable.

What is Infant Torticollis?

In newborns torticollis can occur due the positioning in the womb or may be due difficult childbirth. This is called infant torticollis.

It can be disturbing to see your baby has a tilted head or having problem in turning his or her head. But most of the babies don’t feel pain from torticollis.

There are two types of torticollis:

  • Congenital muscular torticollis : It happens when when baby is born with the twisted neck.
  • Acquired torticollis : It occurs as a side effect of the other health conditions.

Signs and Symptoms of Torticollis

torticollis in infants

Congenital Muscular Torticollis

  • There is a limited range of motion in the head and neck.
  • The head tilts to one side while the chin tilts to the other.
  • A small mass is sometimes found on the sternocleidomastoid (SCM) muscle.
  • Asymmetry of the head and face, indicating plagiocephaly , may also be present.
  • Musculoskeletal problems, such as hip dysplasia , are sometimes present.
  • Breastfed babies may prefer one side over the other.

Acquired Torticollis:

  • There is limited range of motion in the head and neck.
  • The head tilts to one side while the chin tilts to the other.
  • There may be recurrent episodes, or attacks of head tilting; often these attacks are accompanied by other symptoms, such as vomiting, irritability and drowsiness.
  • Additional symptoms vary according to the cause of the torticollis.

Causes of torticollis

CONGENITAL MUSCULAR TORTICOLLIS

  • Most common cause is that the sternocleidomastoid muscle becomes shortened and contracted.
  • The way the baby was positioned in the womb before birth.
  • Abnormal development of the sternocleidomastoid muscle.
  • Damage to the muscle during birth.

ACQUIRED TORTICOLLIS:

The causes vary widely and range in severity from not so serious to very serious. Some causes of acquired torticollis include:

  • Mild (usually viral) infection
  • Minor trauma to the head and neck.
  • Gastroesophageal reflux
  • Respiratory and soft-tissue infections of the neck.
  • Abnormalities in the cervical spine.
  • Vision problems.
  • Abnormal reaction to certain medications called a dystonic reaction.
  • Up and down movement of head along with uncontrolled eye movements.
  • Sandifer syndrome (a rare condition combining gastroesophageal reflux with spasms in the neck).

Diagnosis:

Torticollis can be diagnosed in three ways:-

  1. Visual and Physical Inspection: For inspection the doctor will move the head of the baby and feel for any resistance from the sternocleidomastoid muscle. If the injury has occurred to the muscle then doctor will look for the scar mark. If acquired torticollis, doctors will ask for the infant’s medical history.
  2. X-Ray: It helps to detect torticollis or any other disorder in the baby.
  3. Ultrasound Analysis: With the help of this imaging technique the doctor can tell for sure if sternocleidomastoid muscle has suffered from the problem or not.

Treatment of torticollis

If your baby has torticollis then you must practice the neck stretching exercises as recommended by your doctor. These exercises will help to loosen the tight neck muscles and strengthen the weaker ones on the opposite side. This will help to straighten out baby’s neck.

TORTICOLLIS EXERCISES:

  • Tummy time :- Laying your baby on the stomach for brief periods while awake is an important exercise because it helps strengthen neck and shoulder musclesand prepares the baby for crawling.
    This exercise is especially useful for a baby with torticollis and a flat head — and can actually help treat both problems at once.
  • Stretching exercises to treat torticollis are most likely to work well if they start when a baby is between 2 to 6 months of age. If you find your baby’s torticollis isn’t improving with stretching, talk to your physical therapist.
  • In addition to tummy time, you can encourage your baby to move to their affected side. For example, if your infant normally turns his head to the left, stand to his right when you’re changing him.
  • For breastfeeding mothers, encourage your baby to feed from the side he doesn’t normally enjoy. All of these movements can strengthen your baby’s neck.

In certain cases, the doctor may suggest taking a baby to a physical therapist for treatment. After treatment has started, the therapist may examine your baby every 2 to 4 weeks to see how treatment is going.

At these follow-up visits, the physical therapist will measure how many degrees the baby can turn their head, this help strengthen the muscles in their neck. They will also check if there is any head shape issues and make recommendations about how to decrease any flatness that may be present.

  • Surgical options:

When physical therapy and home exercises don’t correct your child’s head tilt, surgery may be required. This happens only rarely with babies who have persistent torticollis that doesn’t respond to conservative treatment. Very few children with congenital torticollis will require surgery. The surgery lengthens the sternocleidomastoid muscle and corrects the torticollis.

Hope this article was of help for all our parents!! Please share your comments/queries/tips with us and help us create a world full of Happy and Healthy Babies!!

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