Infant Torticollis - Symptoms and Diagnosis of Babies with Torticollis.
When you notice that your baby has a stiff neck, holds his head to one side or has limited neck movements you should make an appointment with your paediatrician right away.
The sooner torticollis in babies is detected; the better and more efficiently this condition can be treated.
What is infant torticollis?
Torticollis also called wryneck, is a tightness in the neck muscle (sternocleidomastoid muscle). This neck muscle connects the collarbone (sternum) to the temporal bone of the skull (mastoid). Tightening of this muscle causes the head to tilt to one side.
When the condition is present at birth or shortly after birth we call it congenital muscle torticollis. About 1 in 250 babies is born with congenital torticollis.
Often torticollis in babies is not diagnosed at birth or in the first months of life. Symptoms become more obvious as babies grow older and are able to sit up on their own.
Causes of torticollis in babies
What causes the tightness or shortening of the neck muscle?
- Some times a traumatic birth injury causes stretching and scaring of the neck muscle. The scar tissue is sometimes visible as a small lump that slowly resolves over a period of 5 to 21 months.
- Congenital infant torticollis can also be caused by baby’s position in the womb.
- Torticollis is more common in situations where there is lack of space in the womb. For example with multiple births or when there is little amniotic fluid.
Apart from congenital muscle torticollis, the most common type in infants, there are other causes like:
- Abnormalities of the spine
- Eye muscle disorder (Ocular torticollis)
- Neurological imbalance (Benign paroxysmal torticollis)
What are torticollis symptoms?
- Facial asymmetry. One side of the face may seem more prominent or full and the chin may point to the side of the shortened muscle.
- You may notice your baby has restricted neck movements. The head is usually turned toward the side of the tightened muscle.
- Plagiocephaly (flat head syndrome) Plagiocephly is often a result of torticollis. Baby’s inability to change the position of its head during sleep times causes flattening on one side of the skull.
- Sometimes the infants shoulder is raised on the side of the affected muscle.
Diagnose of infant torticollis
Torticollis in infants is diagnosed through physical examination and medical history. Your baby's torticollis can be the result of a traumatic birth injury during breech birth.
Some parents can see or feel a swelling on the neck muscle. In most cases this swelling will disappear in the next 5 to 21 months. The examination of your baby's head and face shape will also help your doctor make a positive diagnose of torticollis.
X-rays and MRI are performed to rule out other possible conditions. Baby's will be tested for other conditions like deformation or misalignment of the hip joint (hip dysplasia) that occurs in 20% of infans with torticollis.
Examination by an ophthalmologist is sometimes necessary to make sure torticollis is not caused by vision problems (ocular torticollis).
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