Many young mothers have heard and read about such childhood pathology as torticollis. Even experienced doctors cannot always see it in a newborn, and therefore the question of how to determine the curvature of the neck in a child remains one of the most burning.
About the disease
Torticollis is an anomaly in which the baby's neck is forced to be in an anatomically incorrect position. Wherein the head of the baby tilts fixedly to the side opposite to the side of the lesion... The cause of this phenomenon is developmental anomalies or injury to the neck muscles, vertebrae or nerves.
The most common diagnosis is in newborns or nursing girls, and in the vast majority of cases, the problem is right-sided... The congenital form of the disease is evident almost immediately after birth. Acquired can occur at any age.
The cause of congenital curvature of the neck is the pathology of pregnancy, intrauterine fetal malfunction, difficult childbirth, birth trauma. Most often - late toxicosis, oligohydramnios, multiple pregnancy, long entanglement of the baby with the umbilical cord around the neck, pelvic and transverse arrangement of the crumbs in the mother's womb, rapid or protracted childbirth, the use of obstetric devices to extract the baby, stimulation of labor, caesarean section.
Acquired forms of pathology usually occur due to traumatic or other effects on muscle tissue, cervical vertebrae, and nerve endings.
- Myogenic (muscle) torticollis is formed both in utero and after birth. During intrauterine development, the reason may lie in the underdevelopment of the sternocleidomastoid or trapezius muscle, in a born child - in their injury or inflammation.
- Bone and articular types of ailment are often the result of a violation of the formation of the vertebrae in the womb (fusion, wedge-like, etc.) or the result of dislocation, subluxation or fracture after birth.
- Neurological (neurogenic) form is formed in babies who experienced a state of hypoxia in the womb or suffered from intrauterine infection. The acquired form develops with cerebral palsy, encephalitis, poliomyelitis, tumors of the spinal cord and brain.
- Compensatory (installation) form the disease is formed in infants, if they have problems with visual and auditory functions, as well as in violation of the rules of care: the baby is put in bed only on one side, toys are hung for him only on one side, he is carried on handles with the head turned only one way, etc.
Identifying symptoms
If the baby has congenital torticollis, then its characteristic clinical signs are usually visible in the first hours after birth or within 1-2 days after birth. The location of the baby's head is inadequate, and doctors report this unpleasant news to the newly-made mother while still in the maternity hospital.
A mild form of congenital pathology may remain unsolved at this early stage. Much will depend on the observation of the parents and the experience of the pediatrician who will observe the baby after discharge from the hospital.
If the cause of the curvature lies in pathological childbirth, in birth trauma, then the first signs can be noticed only by 2-3 weeks after birth. They build up gradually and are usually determined by the orthopedic doctor as part of the first routine check-up, which is done at 1 month of age.
With mild torticollis, parents can up to 2-3 months and no longer even guess that the child is not all right with the neck.
Close observation of the baby will allow you to suspect pathology earlier. A toddler with torticollis has a fixed head tilt to the shoulder. In this case, the chin is turned to the side that is opposite to the side of the muscle damage: if the pathology exists on the right side, then the turn will be to the left and vice versa.
The neck muscles not only provide the head with mobility, but also support the vertebrae in the correct position. Therefore, any disorder - neurogenic, compensatory, articular or bone - will be accompanied by a clear outline and some protrusion of the cervical muscle (usually sternocleidomastoid). The muscle will be tense even at rest.
If an adult tries to gently and carefully turn the head to the central correct position, then he will meet resistance: the little one begins to cry, scream, worry, protest. The head is limited in movement, it is not always possible to turn it, and if it does, the baby quickly returns it to its original painful state.
After 2-3 months, children with torticollis begin to show some facial asymmetry - one eye, an eyebrow and an ear located on the side of the slope are located below the same organs on the healthy side. The eye looks narrower from the affected side, and the shoulder on the side of the slope is somewhat raised.
Bilateral torticollis is most clearly manifested - it is almost impossible not to notice it... In babies with such pathologies, the head is thrown back or, conversely, tucked under the chin to the sternum. Turns to the right and left are limited or impossible.
Osteogenic torticollis, the fault of which was the dysfunction of the vertebrae, can be recognized by the bend unusual for the cervical spine, by the low position of the head.
If the anomaly is of neurological origin, then extremely tense muscles are usually felt on one side of the neck, and inadequately relaxed on the other.
Babies with neurogenic torticollis on the side of the lesion clamp their hand into a fist, on the same side, the leg is bent at the knee, while head movements to the right and left are quite accessible for the child.
The older the child becomes, the more obvious the signs of his torticollis become.... After 6 months, motor dysfunctions become noticeable: the child does not hold his head well, late learns what his peers have long mastered - sitting and crawling.
Such babies crawl asymmetrically, it is more difficult for them to maintain balance in a sitting position, and then standing... They have milk teeth very late.
Over time, deformations of the bones of the skull and face occur, vision and hearing can be damaged unilaterally. Children with torticollis suffer from headaches.
What to do?
If warning signs are found, parents should see a pediatric orthopedic surgeon. You will also need consultations of a neurologist, pediatrician, ophthalmologist and ENT doctor. After the examination, treatment will be prescribed, the basis of which is massage, exercise therapy, physiotherapy, wearing cervical orthoses, etc.
It is important not to delay the treatment, because the earlier the pathology is detected, the more effective the treatment is. When applied for up to six months, therapy brings results and deformities can be corrected in 90% of cases. The older the child becomes, the more difficult it is to treat the curvature of the neck.
A specialist tells more about crooked neck in babies in the video below.
