Torticollis, Congenital (Twisted Neck)
Torticollis, also called wryneck or twisted neck, is a condition caused by tightened or shortened neck muscles. Children with this condition often have poor head control and tilt their head towards one side with the chin turned to the other side. This is usually observed in the first 6 to 8 weeks of life.
Torticollis may be an acquired or congenital disorder, occurring because of gene mutation, dislocation or fracture of the neck vertebrae, infection or inflammation of lymph nodes, abscess in the throat (retropharyngeal abscess) or injury or diseases of the nervous system. In newborns, it can occur because of abnormal positioning of the head in the womb. In older children, it may result from injury to the neck muscles or sleeping in an abnormal position.
Along with the abnormal tilt, children with torticollis may also exhibit painless swelling or a mass in the neck, limited mobility of the neck, flatness on one side of the face and head (plagiocephaly), and pain and stiffness in the neck.
Your doctor will diagnose torticollis based on the birth history and a careful physical examination. X-rays and ultrasound examination of the neck may be done to rule out other abnormalities and confirm the diagnosis. A thorough neurologic exam helps to assess the cause of the disease.
Treatment for torticollis depends on the cause and is generally a conservative approach of physical therapy exercises and medicine including NSAIDs and injection of Botox into the neck muscles. In rare cases, if muscle stiffness persists and limits head movement in children after the age of 1 year, surgery may be considered.