Presentation
Abstract The aim of the present study is to present the results of the surgical management of late presenting cases of congenital muscular torticollis. [ncbi.nlm.nih.gov]
The median age at presentation is 2 months. The characteristic head tilt seen in this pathology is caused by abnormal contracture of the sternocleidomastoid muscle. [posna.org]
Gastrointestinal
- Constipation
Gastrointestinal History : Interview the parents for an infant history of reflux or constipation, 41 or preferential feeding from one side, 15 both of which can contribute to asymmetrical posturing. [journals.lww.com]
Musculoskeletal
- Torticollis
The incidence of congenital torticollis in association with plagiocephaly is 1 in 300 newborns, with the torticollis resulting from pathologically sustained contraction of the sternocleidomastoid. [ncbi.nlm.nih.gov]
Neurologic
- Rotary Nystagmus
The patient's rotary-torsional nystagmus suggested positional vertigo secondary to abnormal saccular function. [ncbi.nlm.nih.gov]
Workup
Physical therapists should obtain copies of all images and interpretive reports, completed for the diagnostic workup of an infant suspected of having or diagnosed with CMT, to inform prognosis. [journals.lww.com]
Treatment
The mean treatment duration was 4.7 months (SD=5.06, range=1–36). Correlations were noted between severity of restriction and treatment duration (r=.31) as well as between presence of a mass and treatment duration (r=.26). [academic.oup.com]
Discussion: Several factors for a successful outcome of CMT were consistent through the literature, these included: proper diagnosis and early initiation of treatment, caregiver compliance with treatment, and consistency in treatment. [dspace.unm.edu]
Surgical treatment Surgical release may be considered in children older than 12-18 months of age with CMT resistant to conservative treatment or in case of facial asymmetry and plagiocephaly development [ 3, 20, 31 ] (Figure 2). [esciencecentral.org]
Treatment Treatment for torticollis depends on the cause and is generally a conservative approach. Treatment includes physical therapy exercises and medical therapy. [orthowestfl.com]
Age at initial assessment, side of involvement and gender were no significant predictors of treatment duration. [6] Most of the children under one year of age can be treated conservatively. [1] Medical Management If conservative treatment is not successful [physio-pedia.com]
Prognosis
In light of the fact that the prognosis and, consequently, the treatment plan vary directly with the presence or absence of synostoses, clinical evaluation also includes cephalometrics, plain skull X-rays, and CT imaging. [ncbi.nlm.nih.gov]
Figure 2 is a flow diagram that can be used to guide practice and inform prognosis. [journals.lww.com]
Etiology
[…] unknown etiology but may be due to birth trauma or intrauterine malposition intrauterine compartment syndrome of the SCM muscle Pathoanatomy normal anatomy SCM muscle origins anterosuperior manubrium and medial clavicle insertion mastoid process of temporal [medbullets.com]
Although "congenital" muscular torticollis is encountered frequently by pediatricians and orthopedic surgeons, there is no uniformity of thought as to its etiology or therapy. There is much confusion as to diagnosis. [jamanetwork.com]
Etiology: There are currently many theories regarding the etiology of congenital muscular torticollis. These are outlined below Birth Trauma Compression on the neck leads to venous compression of the sternocleidomastoid musculature. [posna.org]
The etiology of congenital muscular torticollis is not well understood The main theories attribute congenital torticollis to either 1) abnormal fetal positioning in utero or 2) birth trauma Malposition of the head in utero is believed to cause an “in [pedclerk.bsd.uchicago.edu]
Epidemiology
We analyzed epidemiological, obstetric, perinatal data, physical therapy, physician assessments, and clinical follow-up for two years after diagnosis. [ncbi.nlm.nih.gov]
Introduction Clinical definition "packaging deformity" caused by a contracture of the sternocleidomastoid (SCM) muscle "torticollis" is derived from Latin words " tortus " (crooked) and " collum " (neck) Epidemiology demographics most common cause of [medbullets.com]
Epidemiology: Overall, the estimated incidence of congenital muscular torticollis is Clinical Findings: The typical head posture results from the contracted SCM: the ear on the side of contracture is tilted towards the ipsilateral shoulder while the chin [posna.org]
Sternocleidomastoid muscle Etiology/Epidemiology CMT occurs in 0.4 to 3.94% of births according to different sources [6] [4] [5]. It is the third most common musculoskeletal abnormality in infants [6] [1] [4]. [physio-pedia.com]
Pathophysiology
Pathophysiology Unilateral shortening of sternocleidomastoid muscle IV. Associated Conditions Congenital asymmetric contractures of hip abductors Unilateral Congenital Hip Dysplasia Unilateral Metatarsus Adductus V. [fpnotebook.com]
The right side was more commonly affected.[ 6 ] The etiology of CMT and pathophysiology behind SCM impairment is still unknown. [ncbi.nlm.nih.gov]
Role of the vestibular system in the pathophysiology of spasmodic torticollis. J Neurol Neurosurg Psychiatry. 2001 Sep. 71(3):285-8. [Medline]. Munchau A, Corna S, Gresty MA, et al. [emedicine.medscape.com]
Prevention
Counsel parents on the importance of “tummy time” in the treatment of CMT and prevention of positional plagiocephaly. Guide parents on strategies to treat CMT and prevent positional plagiocephaly. [pedsinreview.aappublications.org]
What can I do to prevent my baby from getting congenital muscular torticollis (CMT)? Sorry, but there’s no known prevention for CMT. [thebump.com]