(Health Korea News / Jang Dae-hyun) ‘Torticollis’ refers to the head tilting to one side. If a child’s head continues to tilt to one side even when placed in an upright position, infantile torticollis should be suspected. It is a relatively common disease that occurs especially in newborns and infants from birth to less than 5 months of age, and if left untreated, it can cause deformities not only in the face but also in the spine, shoulders, and pelvis during the growth period.
When feeding or trying to put the baby to sleep, if the baby turns his head to one side or a small lump can be felt on one side of the neck, torticollis may be suspected. It is also necessary to check for symmetry in left and right development, such as whether the baby’s back of the head, forehead, eyes, or jaw shape is asymmetrical.
There are various causes of neck tilt in infants and toddlers. There are congenital muscular torticollis, which accounts for 60-70% of torticollis in children, as well as postural torticollis (developmental lateral torticollis), ocular torticollis, and bone torticollis.
Muscular torticollis is caused by abnormalities in the sternocleidomastoid muscles on both sides of the neck. When the sternocleidomastoid muscles are damaged, the muscles on the damaged side contract, tilting the head and naturally turning the chin to the opposite direction. The exact cause is unknown, but it is thought to be caused by improper posture during the fetal or neonatal period. In addition, ocular torticollis can be suspected in cases of various eye diseases such as strabismus. In rare cases, torticollis can be caused by congenital problems in the cervical spine, brain, and spinal cord.
If muscular torticollis is suspected, an ultrasound examination is performed to check for lumps and differences in thickness of the sternocleidomastoid muscle. The child’s developmental status, eye movement, and X-RAY images of the cervical spine or clavicle are used to determine if there are other causes. If neurodevelopmental abnormalities are suspected, additional tests are performed. Muscular torticollis may improve naturally, but it is important to seek early treatment if symptoms appear. Early treatment can prevent problems such as facial asymmetry, temporomandibular joint problems, and scoliosis.
Treatment for pediatric torticollis basically involves rehabilitation treatment to correct the alignment of the neck and to enable symmetrical growth, such as stretching the shortened sternocleidomastoid muscle and strengthening the muscles of the opposite neck that are relatively weak.
Myositis is a tumor in the muscle, and the length of the sternocleidomastoid muscle is shortened. It should be treated with proper stretching. After 3 months of age, the physical and emotional resistance increases rapidly as the child begins to hold up his or her neck on his or her own. For effective treatment, it is important to detect symptoms early and start treatment before 3 to 4 months of age.
If the condition does not improve even after rehabilitation treatment, surgical treatment such as sternocleidomastoid muscle resection can be considered. Postoperative rehabilitation treatment is also important. If rehabilitation treatment is not performed properly, symptoms may reappear due to problems such as adhesion.
Since most cases of pediatric torticollis can be cured with rehabilitation treatment alone if discovered early, it is best to visit a hospital as soon as possible if symptoms appear. Most cases of torticollis are caused by problems with the neck muscles, but if torticollis is caused by problems with the cervical spine or eyes, it can get worse or cause serious side effects if diagnosed incorrectly and treated with physical therapy, so it is essential to consult a specialist and receive appropriate treatment. (Written by Professor Dae-Hyun Jang, Department of Rehabilitation Medicine, Incheon St. Mary’s Hospital, Catholic University of Korea)
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Source: www.hkn24.com
