What is torticollis?
Torticollis is a sign of underlying disorder that is characterized by asymmetric posturing of the head and neck. The majority of infants who present with torticollis during the first year of life have congenital muscular torticollis (CMT). CMT is caused by tightness in the neck muscles called the strenocleidomastoid (SCM). A study, done by UCSD Medical Center and UCSF School of Medicine, reports that as many as one in six newborns have torticollis. CMT can be identified as early as birth or during the first few months of life.
The child with torticollis typically has the general ability to turn his/her head in all directions when prompted, however full end-range motion may be limited in one or two directions on the non-preferred side. The child may demonstrate a favored head posture that can be mild or severe. The extent of the head tilt/turn preference may vary during the day, but is usually most noticeable when the child is sleepy, fussy or hungry. Infants who prefer to turn their head towards one direction (especially during sleep) are at high risk of quickly developing cranial asymmetry or cranial flat spots.
How can I recognize it in my child?
Signs of torticollis may include any combination of the following symptoms:
- Preference to tilt head sideways towards one side
- Preference to turn face towards one side (Referring to past baby photos can help parents recognize these postural preferences)
- Tightness and/or palpable mass in the SCM neck muscle (smaller than pea-size)
- Flattened area(s) on baby’s head
- Ear, eye, cheek, jawline, and/or forehead on one side of face may be more prominent or relatively shifted in position compared to the other side
- Lack of full end-range motion of neck turning or tilting towards one or both sides
- Trunk may appear to curve or arch sideways to one side
- Slow to acquire gross motor skills (tummy time, rolling etc.)
Torticollis can lead to the following associated conditions:
- Head shape asymmetries or flat spots
- Gross motor delay (ie dislikes “tummy time”) – See “Gross motor milestone checklist” for details
- Asymmetric facial features
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