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Congenital (Infant) Torticollis

Condition: Torticollis is the abnormal positioning of the head in which the head and chin are tilted to either side of the body due to contraction or shortening of neck muscles.

Background: The condition is more common in males, firstborns, and breech or single deliveries. Disruption of the nerves or blood supply to the neck muscle also is associated with the condition.

Risk Factors:  More common risk factors of abnormal head positioning are plagiocephaly, or associated with genetic syndromes, including Trisomy 21, Klippel-Feil, Marfan, Larsen and Morquio. The condition also is associated with bony tumors or abnormalities, infection, surgery, movement disorders, and gastric reflux.

Symptoms: Symptoms of congenital cases are evident by six weeks of age.

History and Physical Exam: Health care providers obtain a complete prenatal and birth history, and family history. A patient’s head and neck posture, range of motion, muscle tone and reflex, and strength are assessed. Pediatric patients are evaluated for appropriate motor skills.

Diagnostic Process: Other tests to detect bony abnormalities, injury, or tumors include x-ray, MRI and CT scans.

Rehab Management: To improve neck rotation, infants may need physical therapy and parent education for correct feeding, handling, and sleeping positions. Anti-reflux medication, muscle relaxants and antibiotics are other treatments to manage the condition. Kinesitaping, positioning TOT collars and botulium injections can also help. Most cases resolve by 6 months of age.

Other Resources for Patients and Families: Parent and patient education are crucial to treat torticollis and prevent posture and facial deformities.

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