Torticollis in infants: symptoms, signs, causes, treatment
Torticollis in newborns, infants, babies and pupils, "twisted neck" allocate doctors. They reflect developmental phases in which pathology is detected, and there are specific signs of pathology.
The Clinical symptoms depend on the time definition of the disease. A child's body grows and changes all the time, so the clinic is slightly different. The only similar trait of the disease in children of all ages – lateral position of the head and neck with asymmetrical muscle tone.
Classification and causes of disease
Torticollis in infants is classified according to the causes of the following types:
Purchased "twisted" neck is divided into:
- Neurogenic – occurs when pathology of the nervous system;
- Ophthalmic is in violation of the innervation of the ocular and facial muscles;
- Orthopedic – due to anomalies of the structure of the cervical spine;
- Ear – hearing on one side.
Congenital torticollis in infants occurs in utero. With incorrect position of the fetus in the uterus, anomalies of the muscular system, the compression of the cervical spinal cord, there is an asymmetric development of skeletal muscles of the upper body.
There are cases of congenital diseases on the background of a difficult birth, when a strain occurs when muscle tissue difficulties with the release of the fetus from the birth canal.
The Curve of the neck in infants may be a consequence of intrauterine pathology, the signs of which are not identified in a timely manner. It is not always possible to detect the symptoms of the disease after the baby is born, as the paralytic muscular frame, the child does not hold his head, so diagnosis is problematic.
Only the dynamic observation of the child shows that muscles are formed not according to age peculiarities. A few months after the baby is born the doctors form a diagnosis of congenital torticollis in infants.
This situation is favorable in terms of prognosis since medicine has drugs to enhance muscle tone. Good effect has a therapeutic massage.
The prediction of the disease with age is substantially affected by the causes of disease. If the disease is caused by acquired factors, after their removal, you can achieve a complete cure. Congenital etiology requires correction of the condition of the child throughout life.
If the condition is diagnosed in children of school age, are rare. The main causes of this pathology – a curvature of the cervical spine (scoliosis, osteochondrosis, juvenile dorsal kyphosis).
To Determine congenital Krivoshey immediately after birth. Despite the fact that signs can be "subtle", they exist. Competent doctor will be able with a high degree of reliability to establish the diagnosis. He identifies the following symptoms in infants:
- Club-shaped thickening in the middle part or the lower part of the sternocleidomastoid muscle. They are determined at 2-3 weeks after birth. The plot is dense and practically undisturbed (compared with inflammatory changes)
- At 5-6 weeks the child can trace a clear definition of the contour of the pathological muscle tissue in the neck. Tight cord a few pulls head to affected side;
- head Turning in the opposite direction confirms the hunch.
Clinical signs allow to identify which leg sternocleidomastoid muscle is affected. If baby's head is strongly tilted, clavicular affected leg. With the prevalence of turn – spastic sternal part of the muscle.
If your child has torticollis is not diagnosed in time, the disease will progress! At the age of 3-6 years will be to clearly traced the development of different muscle tissue on both sides of the cervical area.
On the affected side are reduced size and there is a deformation of the face it becomes elongated in horizontal and vertical directions. The eye slit is narrowed, lifted the corner of his mouth, the chin is asymmetrical.
The Scapula and shoulder girdle are shifted, as the child tries to compensate for pathology through the upper body. Violation of posture gradually leads to lateral curvature of the thoracic and cervical spine. Over time, the cervical spine moves not only sideways, but also forward, leading to increased thoracic kyphosis.
encourage parents to memorize the number of grounds on which they will be able to identify the baby's neck curve in the early stages:
- Tilting the head back and tilt to one side (right-sided torticollis occursmore)
- turn the face;
- Skewness of the neck and the location of blades at different levels.
When palpation of the palpation of the neck muscles noted the seal is about 2 cm in diameter, resembling an acorn, or a bean.
Congenital torticollis occurs in 0,49%is 3.5% of infants. Its allocation into a separate form is necessary since the treatment takes place throughout life.
Since 1838, the well-known correlation between pelvic presentation of the fetus and the emergence of asymmetrical muscle tone in the neck. The pathology is complicated by the difficulty of childbirth at such position of the baby.
As a result of rupture of muscles of them is replaced by fibrous tissue, making it impossible physiological growth according to age. On the severity of the pathology affects the degree of dystrophic process. In patients with severe damage to fibrous tissue is able to completely displace muscle fibers in the sternal or clavicular pedicle of sternocleidomastoid muscle.
Distinguish 2 forms of the disease:
When infiltrative form determined by palpation of the fluid in the thickness of the muscular tissues of the neck. It can be detected within a few days after birth. Initially, infiltration has a solid consistency, but over time increases in size and becomes soft. Year liquid contents of muscle tissue disappears on its own.
In dystrophic form a liquid in the thickness of the sternocleidomastoid muscle is not palpable. In newborns, this form can occur unnoticed until the age of 2-3 months. In other cases, immediately after birth the child is traced asymmetric development of the skull, the offset of the head. When the feeling of the sternocleidomastoid muscle is a soft consistency due to the lack of fibrous degeneration of the fibers.
If both legs shortened? signs of torticollis can be traced in the external examination of the child: note the strong tilt of the head and offset to one side in the opposite direction.
Other signs of congenital torticollis in infants:
- Cervical scoliosis – lateral curvature due to the asynchronous tone of the muscle tissues;
- Occipital compensation – the nape is installed on the middle of the healthy side;
- shoulder Girdle with the patient side is higher than on the opposite;
- Scoliosis of the thoracic spine in children 3-7 years
- the asymmetry of the skull tightness down the corner of the mouth, eyes, wing of the nose on the affected side
- Healthy half of the face is increased in width and reduced in height
- Palatal arch on the side of lengthening the muscle, and the ear is increased in width.
The Treatment of the above symptoms should be started as early as possible. This will reduce the negative impact of diseases during its progression.
What treatments are available
To Treat Krivoshey in the child in conservative and operative methods. The choice of method depends on the cause of the pathology and nature of the flow.
Conservative treatment "twisted" neck:
- Heat treatments
- Electrophoresis with potassium iodide;
- Corrective gymnastics.
Treatment of diseases of the thermal treatments is used to accelerate blood flow and enhance the resorption of fluid in congenital infiltrative form of the disease. For warming the neck area apply paraffin baths, hot water bottles, bags of sand.
Electrophoresis with iodine provides a resolving action and contributes to the rapid disappearance of inflammatory lesions in muscle tissue. It also inhibits the development of fibrosis.
Attention! UHF-therapy cannot be used because it promotes the growth of non-functional fibrous tissue at the site of damaged muscle fibers.
With the help of massage can be cured acquired forms of pathology in newborns and infants. They still can't do gymnastics, so massages are a primary treatment option for the disease.
Massage with the curve of the neck should be carried out on the convex side in the projection of the sternocleidomastoid muscle. First, be sure to conduct a gentle caress, as the vigorous movements will contribute to the contraction of the muscles. On the opposite side of the trapezoid is desirable to massage the muscle that is the antagonist of the sternocleidomastoid muscle, therefore contributing to the reduction of head turning.
Self-corrective gymnastics is assigned to the older children. Before performing exercises the child specialists conduct a course of study that allows you to teach baby cautious movements, synchronicity exercise. For babies, doctors recommend special exercises to the parents that when the disease should be performed 3 times a day.
Children 4-5 years with a twisted neck should be treated by corrective movements to attract the attention of little lighting effects or sound. There are special devices, which are located on the sides of the affected muscle helps to turn your head when performing charging.
In severe cases, doctors prescribe plaster collars, headbands and styling.
How to correct curvature and to prevent the consequences by Kozlowski
Styling by Kozlowski usedfor the first months of life when you are unable to perform corrective head movements. To maintain the torso in the correct position when using sandbags. Both sides of the neck and armpits of the child privinchivayutsya cotton-gauze pillows. For the infant of 3-4 months-created special pillows with cardboard inserts.
To Cure the disease with dressings of rods. Device hold the child's head and prevent the convergence of the legs of sternocleidomastoid muscle. The disadvantage of this method consists in causing unpleasant feelings that kids carry with difficulty.
Please note! Not to intensively treat the child massage. Statistics show that if you are frequently massaging children become irritable and easily excitable. Against this background, there is a rapid weight loss. To avoid the consequences, you need to alternate massages with electrophoresis.
Methods of prevention
Prevention "curve" of the neck allows not only to prevent the relapse of the disease and to eliminate the curvature of the vertebral column.
Daily passive corrective gymnastics contributes to the lengthening of the fibers of sternocleidomastoid muscle and to prevent damage during growth.
For prevention doctors recommend the following exercise:
- Slowly tilt your head in a healthy way;
- at the same time turn it in the opposite direction;
- do Not exercise through the pain.
Preferably 2-3 times a week to do massage. Normalize the diet and go for a walk in the evenings in the fresh air in 1-2 hours.
When Krivoshei contraindicated weight lifting and heavy exercise.
- it is Important to identify Krivoshey in the early stages;
- Treatment is prescribed depending on the causes and forms of disease;
- Effective therapy involves the combined procedure;
- to cure the congenital form, it takes a few years.
According to statistics, if treatment is commenced not later than 3 months, in 65% of cases can be cured Krivoshey infiltrative. In dystrophic type the success of the therapeutic procedures was 81%.
Consolidating the result lasts for at least 1 year. Treatment can be stopped only when the muscle from the side of the lesion is slightly longer counterpart on the opposite side.
Optimally, if overcorrection persists up to 3 years old child. In subsequent damaged muscle will be able to compete with a healthy and fully grow.
In 20-40% of children the use of conservative treatments do not bring results, so appointed surgical treatment. In infants the operation can be performed after the year, but because of the complexities and serious consequences, the intervention is usually carried out after 3 years.