TORTICOLLIS (Wryneck) |
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DESCRIPTION
Torticollis is shortened neck muscles or chronic neck-muscle spasm that causes the head to turn and bend. The central nervous system--including the brain, the coverings of the brain (meninges), and the spinal cord -- and peripheral nerves and the muscular system are involved. Torticollis can affect both sexes but is more common in females of all ages.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
Psychotherapy or counseling if the cause is stress-related.
Surgery to lengthen neck muscles if the cause is congenital.
Physical therapy (sometimes), including gentle massage.
SIGNS & SYMPTOMS
The following may be permanent or intermittent:
Head that turns sideways and bends down.
Neck-muscle spasm that is sometimes painful.
CAUSES
For constant torticollis:
Birth defect.
Injury to neck muscles or vertebrae at birth or later.
Neck-muscle inflammation.
For intermittent torticollis:
Stress and psychological conflict.
RISK FACTORS
Sleeping in an awkward position.
Emotional disturbances, such as neurosis or hyponchondriasis.
PREVENTING COMPLICATIONS OR RECURRENCEStress-related forms can be prevented in your child with stress-reduction techniques, including biofeedback.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood tests for infection and inflammation.
X-rays of the spinal column in your child's neck.
POSSIBLE COMPLICATIONSWithout treatment, the congenital form becomes permanent, causing an unattractive, abnormal appearance of the child's head and neck.
PROBABLE OUTCOME
Congenital torticollis can usually be corrected with muscle-stretching exercises or surgery.
Other forms will improve or heal with treatment. Healing time varies. Some cases require treatment for several years.
TREATMENT
HOME CAREIf your infant has signs of torticollis:
Ask your doctor or physical therapist for muscle-stretching exercises to do with the child twice a day.
Place attention-getting objects in the crib opposite the side that the head turns.
For non-congenital forms of torticollis:
Your doctor may recommend that your child wear a neck brace.
Relieve pain from neck spasms with heat. The child should take hot showers or use hot compresses, deep-heating ointments, or heat lamps.
MEDICATION
If the child's condition is caused by injury or inflammation, your doctor may prescribe muscle relaxants and pain relievers.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
Normal activities may be resumed as soon as symptoms improve.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?Yes.
CALL YOUR DOCTOR IF
Your infant has symptoms of torticollis.
Your child has neck pain or spasms that persist longer than 1 week.
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