Dr. Ebraheim’s educational animated video describing the congenital muscular torticollis.

Congenital Muscular Torticollis is usually caused by contracture of the sternocleidomastoid muscle and usually occurs in infants. The cause of congenital muscular torticollis is unknown. It may be caused form pressure on the muscle or compartment syndrome of the muscle. The child holds the head towards the affected side with the chin rotated towards the opposite side. There is difficulty in turning the head due to a tight and shortened sternocleidomastoid muscle. It is a common neck problem in childhood and the condition usually resolves itself spontaneously over a period of several months.
Conditions associated with congenital muscle torticollis:
•Molding disorder or packaging deformity such as hip dysplasia (DDH) and metatarsus adductus (up to 20%). Usually delivery is traumatic and probably breach.
•Child will have a firm palpable mass within the first four weeks of life.
•Child will also have a head tilt.
X-rays of the cervical spine are needed to exclude other conditions such as rotatory C1-C2 instability and Klippel Feil syndrome. Ultrasound is important as it can differentiate between mild cases and severe fibrosis.
Differential diagnosis of Congenital Muscular Torticollis:
•Rotatory Atlanto-axial instability/ Grisel’s disease
•Klippel Feil syndrome.
These conditions are serious.
Treatment: the condition of Congenital Muscular Torticollis usually resolves spontaneously in about 90% of infants by passive stretching in the first year. Passive stretching technique should include lateral head tilt away from the affected side and chin rotation towards the affected side. Treatment may be guided by the findings in ultrasound examination of the muscle. Surgical treatment by Z plasty is done if the child is older than 1 year with severe limitation or rotation. Ocular examination in older children.

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Background music provided as a free download from YouTube Audio Library.
Song Title: Every Step

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