Document Detail


Congenital muscular torticollis: current concepts and review of treatment.
MedLine Citation:
PMID:  16470158     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: The purpose of this review is to better understand the spectrum of disease in torticollis, which is the third most common pediatric orthopaedic diagnosis in childhood. Besides the benign muscular tightness of the sternocleidomastoid muscle leading to the classic head position, the differential diagnosis of the wry neck include sequelae to inflammatory, ocular, neurologic or orthopedic diseases. Patients present with a stiff and tilted neck, and therefore require a thorough and systematic work-up, including a complete physical and neurologic examination and cervical spine radiographs. RECENT FINDINGS: Recent findings show that magnetic resonance imaging of the brain and neck is no longer considered cost-effective, or necessary, in congenital muscular torticollis. Observation and physical therapy, with or without bracing, is usually an effective treatment in most cases, especially if instituted within the first year of life. Botox has recently been shown to be an effective intermediate method of treatment for more resistant cases of congenital muscular torticollis. In those presenting after the age of 1 year, there is an increased rate of sternocleidomastoid muscle lengthening. The lengthening may improve the range of motion, but not necessarily the plagiocephaly, facial asymmetry, or cranial molding. SUMMARY: It is important to differentiate muscular from nonmuscular torticollis. Congenital muscular torticollis is benign; missing a case of nonmuscular torticollis could be potentially life threatening.
Authors:
Twee T Do
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in pediatrics     Volume:  18     ISSN:  1040-8703     ISO Abbreviation:  Curr. Opin. Pediatr.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-02-10     Completed Date:  2006-05-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9000850     Medline TA:  Curr Opin Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  26-9     Citation Subset:  IM    
Affiliation:
Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. twee.do@cchmc.org
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Botulinum Toxin Type A / therapeutic use
Humans
Infant
Infant, Newborn
Neuromuscular Agents / therapeutic use
Physical Therapy Modalities
Torticollis* / congenital,  diagnosis,  therapy
Chemical
Reg. No./Substance:
0/Botulinum Toxin Type A; 0/Neuromuscular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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