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Congenital Torticollis

Summary

Congenital torticollis, also known as congenital muscular torticollis (CMT), is a condition where the neck muscles (specifically the sternocleidomastoid muscle) become shortened, limiting the movement of the neck. As a result, the infant may tilt their head towards the side of the shortened muscle and rotate it to the opposite side. This condition may be associated with other problems such as head shape deformities (plagiocephaly) or developmental hip dysplasia, and these conditions can sometimes affect each other. It’s important for healthcare providers to rule out other causes such as eye problems, spinal issues, or neurological conditions.

Diagnosis and When to Seek Help

If you notice that your infant has difficulty turning their head or appears to tilt it in one direction consistently, it may be a sign of congenital torticollis. It’s essential to consult a healthcare provider to confirm the diagnosis and rule out any other potential causes. A thorough physical exam, along with a review of the child’s medical history, will help in determining the best course of action.

Management

Treatment for congenital torticollis typically involves:

  • Carer education on positioning: Parents and caregivers are taught how to gently position the infant in ways that encourage normal neck movement.
  • Physiotherapy: Physical therapy exercises can help improve the flexibility and strength of the neck muscles.
  • Botulinum toxin injections or surgery: These are reserved for severe cases that do not respond to conservative treatments.

Follow-Up and Monitoring

Ongoing follow-up with a healthcare provider is important to monitor the progress of the condition. Regular assessments help ensure that the neck muscles are improving and that no additional complications, like cranial deformities, are developing. If the condition doesn’t improve with conservative treatments, additional interventions may be needed.

History and Exam

Key diagnostic factor

  • Presence of risk factors

Other diagnostic factors

  • Twin birth
  • Unvaried supine sleep and resting position
  • Decreased prone awake time
  • Head tilt

Risk factors

  • Plagiocephaly
  • Breech delivery
  • Caesarean section delivery
  • Twin A (lower in utero)

Diagnostic Investigations

1st investigations to order

  • Cervical spine X-ray
  • Pelvic X-ray
  • Hip ultrasound

Investigations to consider

  • Neck ultrasound
  • Skull X-ray
  • Cervical/cranial MRI

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      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

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      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

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      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

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