TORTICOLLIS

Torticollis, wry neck or stiff neck refers to a condition in which the patient keeps the head tilted to one side due to a spasm of a neck muscle. 


Torticollis In The Newborn
The typical story is that the mother notices a sudden new swelling, the size of a big marble, on one side of the neck when the baby is about 2 weeks old. This is called ‘congenital muscular torticollis’ or ‘sternomastoid swelling’. The baby is not much bothered by it, but tends to keep the head tilted to one side. The swelling disappears spontaneously after 2 to 4 months. If it persists, that side of the face starts looking different from the other side.

CAUSES: The cause of this condition is uncertain, though it is often associated with a breech or forceps delivery. In some cases, a congenital dislocation of the hip also occurs. 

TREATMENT: The treatment consists of stretching the affected neck muscles by slowly moving the child’s head away from the side of the swelling. This is to be done quite frequently, throughout the day. I often tell the mother to do it whenever she changes the baby’s diaper. If the torticollis persists, your doctor should refer the child to an orthopaedic surgeon who will decide if surgery is needed. If the torticollis is noticed right from birth or if it persists when noticed later on, your doctor would like to have an X-ray of the neck taken to rule out any abnormality of the vertebrae, which may call for surgery.


Torticollis In Older Children
This is usually due to an unusual posture, an injury, as secondary to a sore throat, due to a problem with the spine or due to a drug given to check vomiting. Check with your doctor if any investigation or treatment is required.

11 February, 2013