Torticollis In A Child – Know How To Manage It!

Torticollis In A Child – Know How To Manage It!

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By Dr. Rishavdeb Patra, Pediatric Surgery

The word “torticollis” is made with the combination of two Latin words “tortus” and “collum” which mean “twisted neck.” The condition is more common in children compared to young.

Torticollis is also known as wryneck in which the head of children tilts towards one side. The condition can be easily diagnosed by a physical examination.

Types of Torticollis-

Torticollis is generally categorized into two types: Congenital and Acquired

  • Congenital Torticollis: If the child is born with this condition, it is known as congenital muscular torticollis. It is more common compared to acquired Torticollis. It is usually treated with the help of physiotherapy or stretching exercises. This helps to cure the asymmetry in the shape of the face and head.
  • Acquired Torticollis: If children acquired this condition after infancy, it is known as Acquired Torticollis. It usually occurs after 4 to 6 months of infancy. This condition requires immediate medical attention.

Cause of Torticollis-

Congenital torticollis occurs when the sternocleidomastoid (SCM) muscle of an infant contracts and shortens. This will cause a restriction to the mobility of the head.

Here are a few reasons why the SCM muscle become narrow and cause this problem:

  • The position of the baby in the womb
  • Abnormal development of the SCM muscle
  • Damage or trauma to the muscle during birth

Acquired torticollis is more severe and occurs due to the following:

  • Mild infection (usually viral)
  • Minor trauma to the neck and head
  • Respiratory infections of the neck
  • Gastroesophageal reflux (GERD)
  • Vision problems (called ocular torticollis)
  • Cervical spine abnormalities like atlantoaxial subluxation
  • Reaction to certain medications (called Dystonic Reaction)
  • Sandifer syndrome
  • Spasmus nutans

How to Manage Torticollis in a Child?

If the condition is not severe or chronic, it is easy to manage torticollis with the help of physiotherapy. There are certain exercises which help to stretch the SCM muscles and encourage the child to turn his/her child. Changing sleep position will also help a lot to manage this condition.

Other treatment and tips include:

  • Turn the baby to the affected side while feeding.
  • Place the toys to the affected side so that they turn.
  • Let them toss and turn while playing on the bed.
  • Let them play with their hands and feet.

 

Surgery:

Operative intervention is required if Torticollis persists beyond 12 months of age and if there is facial hemihyperplasia

Take Away

There are many treatment options available for managing torticollis. However, it is best to consult a Pediatric Surgeon first. Noticing your child carefully for the first 6 months will help to detect the condition in its early stage and hence can be cured easily.