The torticollis in children-etiology, symptoms and treatment

Abstract

The aim of the work is to present the origin, clinical picture, differential diagnosis and treatment of various types of torticollis in children. This disease has a different etiology but a few similar symptoms. The torticollis results not only in the asymmetrical position of the head and neck, causing distortion of the face and skull, but also leads to asymmetry of the trunk and contributes to scoliosis. The work discusses the methods of managing a child with an asymmetrical position of the head and neck. The torticollis may be caused by: increased tension and shortening of one of the sternocleidomastoid muscles (congenital muscular type), structural bone changes of the cervical vertebrae (congenital sceletal type) or a consequence of the inflammatory process, vision or hearing disorders (acquired type). Treatment of torticollis is a long-term process that requires a lot of parents’ involvement. Very good results are brought by the early start of physiotherapy and diligent implementation of the recommended exercises. The initiation of physiotherapy in the advanced stage of the disease is usually not very effective and may expose the child to long-term complications. For that reason, the work closely discusses physiotherapy process in children with the muscular torticollis. In difficult cases, with ineffective rehabilitation, botulinum toxin is injected into the muscle and finally surgical treatment involving the intersection of three sternocleidomastoid muscle trailers is performed.