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]

Presentation There are different presentations of children with CMT, the most common is an obvious head tilt toward the affected side with the chin pointing to the contralateral side. [massagetoday.com]

• Swelling

  The swelling or "tumor," [jamanetwork.com]

  Bleeding and swelling create pressure on the muscle. Eventually, scar tissue forms and replaces some of the muscle. Another theory suggests that the condition develops while the infant is still in the womb. [mendelsonortho.com]

  Symptoms: Limited range of motion One shoulder is high on one side of the body Stiffness and/or swelling of neck muscles The head tilts to one side and the chin points to the opposite shoulder. [anaheimregionalmc.com]

  Along with the abnormal tilt, children with torticollis may also exhibit painless swelling or a mass in the neck, limited mobility of the neck, flatness on one side of the face and head (plagiocephaly), and pain and stiffness in the neck. [riversideorthopedics.com]

• Surgical Procedure

  We conclude that fine-needle aspiration provides a fast and accurate diagnosis of neck masses in infants who have congenital torticollis, thereby avoiding surgical procedures in this very young age group. [ncbi.nlm.nih.gov]

  Surgical Procedures Surgery may be needed to correct torticollis and can lengthen the short muscle. [anaheimregionalmc.com]

  Back, Neck & Spine You’ll have the advantage of the latest surgical and non-surgical procedures in back and neck pain. [mendelsonortho.com]

• Fever

  If the child has signs of fever, infection or abnormal neurology, appropriate imaging should be performed to establish a cause. Most children will have a muscular torticollis and can be managed with simple analgesia. [rch.org.au]

  Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized [nejm.org]

  In addition, children who develop painful torticollis at the same time as a fever that is caused by an infection in the pharynx (cavity behind the nose, mouth and larynx) or retropharyngeal space (the area behind the pharynx) need to see a doctor immediately [childrenshospital.org]

  […] breathing or swallowing Pins-and-needles feeling or numbness in your arms and legs Urinary hesitancy, urinary or fecal incontinence Weakness in your arms and legs Impaired speech Difficulty walking If the spasm of the neck muscles is associated with fever [emedicinehealth.com]

• Disability

  Please enable JS and disable any ad blocker [contemporarypediatrics.com]

  In some cases, people who become disabled from the pain of torticollis may have difficulty performing daily activities, may no longer be able to drive, and may develop depression. [emedicinehealth.com]

  Passive ROM and symmetrical head posture are important body structure characteristics, but they are only one part of the ICF disablement model. [journals.lww.com]

• Fatigue

  This is achieved by using age-suitable stretching and musculoskeletal strengthening exercise program, which helps in decreasing muscle fatigue and stress Use of special child neck collar (called TOT collar), after the age of 4 months Application of warm [dovemed.com]

  They should be advised that preferential positioning is often observed during times of fatigue or illness, and that reevaluation is warranted if it persists. [journals.lww.com]

• 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]

• Hip Dislocation

  Screening of congenital hip dislocation is mandatory because the physiopathology is the same in both diseases. A remaining torticolis after 18 months of age may be an indication to sternocleidomastoid muscle lengthening. [ncbi.nlm.nih.gov]

  CMT is recorded as is the third most common congenital musculoskeletal anomaly after dislocation of the hip and clubfoot [ 1, 5 ]. [esciencecentral.org]

  A history of congenital dislocation of the hip was noted in 2 patients (cases 8 and 12) that former was operated in childhood but the latter presented with neglected bilateral congenital hip dislocation. [bmcmusculoskeletdisord.biomedcentral.com]

• Muscle Spasticity

  It decreases spasticity to enable the manual stretching. Based on the same concept of muscle spasticity reduction these agents have been used in CMT by experienced practitioners for refractory to manual stretching cases [ 22 ]. [esciencecentral.org]

• Dystonia

  Cervical dystonia This rare disorder is sometimes referred to as spasmodic torticollis. It causes neck muscles to contract in spasms. If you have cervical dystonia, your head twists or turns painfully to one side. [healthline.com]

  Answer : The onset of cervical dystonia in early childhood is generally a different condition than in adults. Babies can be born with twisting of their necks. This is called congenital torticollis. [torticollis.org]

  With spasmodic torticollis (cervical dystonia), there may be neck muscle spasms that are sustained (tonic) or jerky (clonic). [emedicinehealth.com]

  Torticollis is a frequent cause of plagiocephaly (flattening of one side of the head) and asymmetric facies (see also Cervical Dystonia ). [merckmanuals.com]

• Irritability

  […] develop persistent torticollis and need surgical intervention Some rare malformations of the vertebrae can also cause congenital torticollis Acquired Torticollis Injury or inflammation from a range of conditions can cause spasms of cervical muscles or irritation [pedclerk.bsd.uchicago.edu]

  […] turned to one side More difficulty turning his or her head to one side as compared to the other More difficulty breastfeeding or taking a bottle from one side as compared to the other A pea size, firm bump that can be felt on the side of the neck Skin irritation [700childrens.nationwidechildrens.org]

  With a condition called benign paroxysmal torticollis, there may be recurrent episodes, or “attacks,” of head tilting; often these attacks are accompanied by other symptoms, such as vomiting, irritability and/or drowsiness. [childrenshospital.org]

  The following symptoms suggest injury or irritation to the central nervous system and should be medically evaluated immediately especially if they suddenly develop. [emedicinehealth.com]

  Any inflammatory process that irritates the muscles, nerves, or vertebrae—including surgery or trauma—can produce a reflex spasm resulting in this form of torticollis. [moveforwardpt.com]

• Neck Stiffness

  It is also sometimes referred to as wry-neck, stiff-neck, caput obstipum, crooked-neck and twisted-neck. [ncbi.nlm.nih.gov]

  Congenital muscular torticollis (CMT) is also sometimes referred to as wry-neck, stiff-neck, crooked-neck and twisted-neck. [massagetoday.com]

  Complications of torticollis include neck deformity and constant neck stiffness and pain. This constant tension may result in muscle swelling and neurological symptoms due to pressure on the nerve roots. [emedicinehealth.com]

• Seizure

  An infant with congenital torticollis underwent chiropractic manipulation, and within a few hours had respiratory insufficiency, seizures, and quadriplegia. [ncbi.nlm.nih.gov]

  ▪ The presence of perinatal asphyxia, jaundice seizures, medication, gastroesophageal reflux disease (GERD) or Sandifer’s syndrome are also recorded 6. ▪ Children with CMT can be assigned to one of three groups 1.Children with a palpable swelling or [slideshare.net]

  […] days Physical Exam: Torticollis is accompanied by vomiting, pallor, irritability, ataxia, or drowsiness Diagnosis: Diagnosis is made based on careful history and physical exam Since the clinical findings can mimic more serious illnesses (brain tumors, seizures [pedclerk.bsd.uchicago.edu]

  The presence of perinatal asphyxia, jaundice, seizures, medication, gastroesophageal reflux disease (GERD) or Sandifer’s syndrome are also recorded [ 12 ]. [esciencecentral.org]

• Vertigo

  The patient's rotary-torsional nystagmus suggested positional vertigo secondary to abnormal saccular function. [ncbi.nlm.nih.gov]

  […] episodes of head tilt that are often accompanied by vomiting, pallor, irritability, ataxia, or drowsiness Etiology: The pathogenesis is unknown Considered to be a “migraine equivalent” disorder Some patients later develop migraines or benign paroxysmal vertigo [pedclerk.bsd.uchicago.edu]

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]

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]

Treatment Treatment for torticollis depends on the cause and is generally a conservative approach. Treatment includes physical therapy exercises and medical therapy. [orthowestfl.com]

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 Options: Surgical Most of the time, this condition resolves by the time the child is a year old. If not, the physician may recommend surgical treatment to release and lengthen the tight muscle. [mendelsonortho.com]

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]

What Is the Prognosis of Torticollis? Prevention of torticollis may not be possible, but the prognosis for torticollis is generally good. [emedicinehealth.com]

[…] 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 [step1.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]

[…] torticollis 3 Arnold-Chiari malformation 4 Atlantoaxial rotatory displacement 5 Paroxysmal torticollis of infancy ML 1 Select Answer to see Preferred Response PREFERRED RESPONSE 1 (OBQ09.2) Tightness in which of the following muscles has been implicated as an etiology [orthobullets.com]

We analyzed epidemiological, obstetric, perinatal data, physical therapy, physician assessments, and clinical follow-up for two years after diagnosis. [ncbi.nlm.nih.gov]

Covers the social and preventative aspects of child health Covers the common diseases of childhood and their treatment with a presenting-problem approach Contextualises the disease in description of social, genetic and epidemiological factors. [books.google.ro]

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 [step1.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]

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]

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]