Neurogenic torticollis in children and adults

Neurogenic torticollis – a neck angle tilted to the side and turning the head, caused by disorders of innervation of the sternocleidomastoid muscle. The frequency of the disease among the forms of pathology does not exceed 5%.

Causes and classification of pathology

Neurogenic torticollis is classified for reasons in the following forms:

1. Hyperkinetic
2. Spastic
3. Paralysis
4. Neurotoxic
5. Reflex.

Hyperkinetic torticollis in children occurs against a background of cerebral palsy. The disease is accompanied by death of neurons in the brain, rolled some regulatory centers. The severity of the disease depends on the extent of the lesion of brain tissues and its causes.

When severe cerebral palsy, there is complete immobilization of the limbs of children. It is almost impossible to cure, as the center falls out the regulation of skeletal muscle of the extremities.

The Spastic form more often in adults is formed on the background of degenerative-dystrophic diseases of the spine resulting in pinching of the spinal nerves. In children, this pathology occurs in dorsal kyphosis youth, when a few of the thoracic vertebrae become wedge-shaped, which increases the thoracic kyphosis of the spine. The condition causes impairment of nerve fibers that Innervate the sternocleidomastoid muscle.

Neurogenic torticollis paralytic type occurs on the background of paresis of skeletal muscles in some diseases of the brain (Alzheimer's, Parkinson's disease).

The Neurotoxic form is formed in case of bacterial infections with lesions of the brain tissue (rabies, meningitis, Lyme disease).

The Reflex curvature of the neck in children occur on the background of diseases of other organs, accompanied by inflammation of the nerve fibers of the cervical plexus (myositis, frozen shoulder).

Symptoms

Acquired neurogenic torticollis is diagnosed in children sometime after lesions of the sternocleidomastoid muscle. Her symptoms are formed gradually and lead to the following clinical picture:

1. Fixed head turning and tilting the neck;
2. Increase the affected sternocleidomastoid muscles in size
3. chest Deformity of the child;
4. Asymmetry of the skull and face;
5. decreased mobility of the head;
6. loss of vision, development of strabismus;
7. Bone changes of the cervical spine;
8. Slowing of psychomotor development of children;
9. the Difference in location of the ears.

The Above symptoms in children are formed not immediately, but gradually. According to statistics, without treatment, from mild to severe forms of the disease may take 2-3 years. High flowrate pathology requires the child's parents daily efforts to save the baby's head in the correct position.

The complexity of the problem necessitates continuous monitoring of the condition of the baby from three doctors: the neurologist, the pediatrician and the orthopedist.

Treatment

Conservative treatment of twisted neck in children is appointed immediately after the detection of pathology. Outpatient doctors recommend massage, medical gymnastics and electrophoresis.

When you perform the massage in children with a wry neck is necessary to observe the following principles:

• On the affected side massaged: sternocleidomastoid and facial muscle
• From the opposite side, stretching the trapezoid muscles;
• Pressure on the muscle fiber should not cause children pain;
• Neurological pathology on the background of a spastic contraction of the sternocleidomastoid muscle requires the use of pharmaceutical drugs. Without them, massage treatments prove ineffective.

With physical therapy and massage treatments to effectively alternate the ronidazoy electrophoresis with lydasum or (10-15 sessions during 1-1,5 months). It will help to resolve the club-shaped thickening of the sternocleidomastoid muscle.

for the attention of parents that in the presence of asymmetric tone facial muscles need surgery. With the help of medical gymnastics and massage treatments it is impossible to eliminate lockjaw.

surgical correction of hypertonicity sternocleidomastoid muscle

facial Asymmetry in children most often forms a neurogenic pathology. This should be considered when surgical treatment. To prevent relapse, sometimes have to resort to surgical operations in children. They are traumatic, but the doctors are not remains alternative.

Distinguished 2 types of surgical interventions in Krivoshei in children:

• Operation Zatsepin – dissection damaged legs sternocleidomastoid muscle and the removal of scarring in the surrounding tissues, eliminating inflammatory and edematous changes;
• Plastic elongation of the legs of the affected musculature.

Inrehabilitation period after both types of surgery the child's head for some time fix a loop of Glisson. In addition, the month the baby is wearing a collar to prevent rotation of the head in a healthy way.

during the course of rehabilitation is the massage, exercise therapy, electrophoresis with potassium iodide.

Parents must pay attention to the fact that the most effective combined treatment of neurogenic torticollis. The use of paraffin, swimming, massage, collars Trench, orthopedic braces, hinges Glisson is not a complete list of conservative methods of treatment of twisted neck in children. Coordinate therapy with your doctor!