You or the nurse may have noticed that your child’s head tilts to one side more than the other, and you might have heard the word “torticollis”. But what exactly is Torticollis?

Torticollis is a situation where the neck is turned, which cause the head to tilt to one side and the chin to tilt in the opposite direction. Acquired torticollis is caused by inflammation or damage to the muscles in the neck or the upper back muscles, which causes the chin to tilt in the opposite direction of the involved muscle. ( For example, if the neck is turned to the right, the affected muscles are on the left side).

What does it look like?

The head is tilted one way - with the chin pointing in the opposite direction of the forehead. If the child’s forehead is tilting to the right, the chin will be pointing left.

Sometimes, there will be other signs, such as:

A lump in the side of the neck that the forehead is pointing to

Facial asymmetry : Face seems abnormal, both sides of the face don’t match

Pain during movement of the neck

Difficulty moving the head and / or neck

Children may experience bouts of vomiting, pallor, irritability, drowsiness, restlessness for hours/days, but most often these symptoms disappear on their own

Tight jaw muscles, muscle spasms, speech difficulty

What causes acquired torticollis?

Damage or inflammation of the muscles - especially the neck or upper back muscles are the more common causes of acquired torticollis in children.

Acute inflammation - inflammation involving muscles or discarded pain or the second most common cause.

Joint problems - mostly in the joints of the cervical spine.

Problems from a source outside of the neck - children who suffer from movement problems or eye problems (i.e. strabismus - cross eyes) may turn their head constantly to prevent double vision

Spontaneous torticollis - characterised by repeated episodes of head tilt together with vomiting, pallor, irritability, ataxia or drowsiness which usually appears during the first months of life

Medication - toricollis can be caused by the effect of certain medication on the muscles

Sandifer syndrome - A syndrome which is characterised by rotational spasm of the neck and abnormal posture

Less common but life threatening conditions - Inflammation of the respiratory system or blood vessels, trauma caused to the cervical spine and tumors in the spine and brain.

Treatment

The treatment of toricollis depends on the cause.

Most cases of acquired torticollis are due to involvement of the muscles and therefore the treatment is anti inflammatory drugs and a neck brace.

* Other causes require the involvement of experts and immediate treatment

Why treat?

To achieve a symmetrical position

To achieve motor skills

To prevent / improve conditions associated with asymmetry

To improve the range of motion in the neck

Last update: March 12, 2020

Sources:

https://www.uptodate.com/contents/acquired-torticollis-in-children?source=history_widget