It’s not uncommon for babies to be diagnosed with both plagiocephaly and torticollis. The relationship between plagiocephaly and torticollis is slightly unusual as causality can go in either direction. In other words, sometimes plagiocephaly can cause torticollis and sometimes it’s the other way round.
Torticollis, or ‘wryneck’ is a muscular condition that prevents a baby from being able to fully turn their head in both directions. A torticollis is a result of an imbalance in the muscles on each side of the neck. These muscles start in front of the neck on the collarbone and breast bone and go diagonally up and back, ending at the base of the skull just behind the ear. The muscle on the right side turns the head to the left and side flexes the head to the right. The left muscle works in the opposite direction and when these muscles work together, they lift the head. (more…)
Torticollis, sometimes referred to as wryneck, comes from the Latin words tortus (twisted) and collum (neck). Infants who have the condition have their head turned and tilted to one side and they struggle to move their head to the opposite side. This blog post explores torticollis in more detail, the different severities of the condition and how to find effective treatment for your baby.
Torticollis (also known as wry neck) is a very common condition which can often develop into plagiocephaly. It is characterised by an inability to turn the head fully in both directions, and there may also be a head tilt towards the affected muscle.
As the muscles tighten and become cramped, pain and discomfort will often be felt, causing your baby to become irritable. In infancy, torticollis can develop in a number of ways. Firstly, newborns can experience torticollis due to maintaining a specific position in the womb or after a difficult childbirth. Acquired torticollis happens shortly after birth, either as a result of some shortening from the position that the baby has been lying in or due to bruising during the birth. However your baby has acquired torticollis, seeking a professional diagnosis and pursuing active treatment is necessary.
This informative blog post explains what to do if your baby has torticollis, helping to prevent the face and skull from growing unevenly, and improving the range of motion of the head and neck of your baby.
You may have noticed that your baby has a tendency to tilt their head to one side and a flat spot on your baby’s head. Having discovered that these symptoms are characteristic of torticollis and a head deformity known as plagiocephaly, you might be trying to decide on the best way forward.
Should you try a course of physiotherapy, osteopathy or chiropractic to treat the plagiocephaly and torticollis, or go straight to your doctor for advice?
Signs and symptoms of plagiocephaly (AKA flat head syndrome) and torticollis
When your baby was only a few weeks old, you may have noticed how he seemed to cock his head whenever he looked at you. Seeing him in other situations, you might have then realised that this was his customary posture. When you tried to move his head away from his shoulder, he may have cried as though you were causing him pain. (more…)
While there may be evidence of a correlation between plagiocephaly and motor delay, it’s currently unclear whether or not this is a cause and effect relationship. However, a recent study investigating the potential ties between plagiocephaly, torticollis and motor development may shed a little more light on the nature of this link. (more…)
Background: Numerous risk factors have been associated with the development of deformational plagiocephaly, although the etiology remains unclear. Torticollis and sternocleidomastoid imbalance are implicated, but reporting is variable. The authors sought to determine the incidence of torticollis/sternocleidomastoid imbalance in deformational plagiocephaly.
Methods: The authors prospectively evaluated 371 infants with cranial asymmetry between 2002 and 2003. Demographic data and medical history were recorded, and a questionnaire was administered. Cranial asymmetry and head rotation were assessed, and variables were statistically analyzed.
Results: Two-hundred two patients were included. Mean age at initial evaluation was 6.1 months (range, 3 to 16 months). Sixty-eight percent (n = 138) were male; 74 percent (n = 149) were flat on the right occiput; 14 percent (n = 28) were from a multiple pregnancy (24 twins, four triplets); 27 percent (n = 54) were premature; and four percent (n = 8) were syndromic. Ninety-three percent (n = 188) of parents did not notice flattening at birth. Ninety-two percent (n = 186) recalled a preferential head position after birth, and in 95 percent of these infants (n = 177 of 186) this improved with age. Only 24 percent (n = 48) of infants had been previously diagnosed or treated for torticollis. Mean cranial asymmetry was 12.5 mm (range, 8 to 25 mm). Ninety-seven percent (n = 195) of infants had head rotational asymmetry of 15 degrees or greater, with more rotation to the flat side. The mean rotational difference was 24 degrees (range 0 to 60; SD 9.8). There was a negative correlation (p = 0.004) between age and head rotational asymmetry (i.e., younger patients exhibited greater asymmetry) and a positive correlation (p = 0.043) between cranial asymmetry and head rotational asymmetry.
Conclusions: The incidence of torticollis/sternocleidomastoid imbalance in deformational plagiocephaly is underreported. Because this condition improves rapidly during early infancy, the findings may be subtle and evidenced only by a history of preferential head rotation. The major cause of deformational plagiocephaly is limited head mobility in early infancy secondary to cervical imbalance
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Serial developmental assessments in infants with deformational plagiocephaly B Lynne Hutchison, Alistair W Stewart, Tristan de Chalain, Edwin A Mitchell Journal of Paediatrics and Child Health March 2012