Congenital torticollis is a birth defect in which the head becomes tilted at or soon after birth.
Birth defects, also called congenital anomalies, are physical abnormalities that occur before a baby is born. "Congenital" means "present at birth." (See also Introduction to Birth Defects of the Bones, Joints, and Muscles.)
The most common cause of congenital torticollis is
Injury to the baby's neck during delivery
The injury may damage neck muscles and/or cause a collection of blood (hematoma) in the neck muscles. These can lead to an abnormal thickening of neck tissue (fibrosis) and neck muscle stiffening (contracture). Very rarely, bones of the spine (vertebrae) are broken or dislocated during birth. Certain gene mutations may play a role.
Other causes of torticollis that develop within the first few days or weeks of life include spinal abnormalities such as
Klippel-Feil syndrome (fusion of the vertebrae in the neck, a short neck, and a low hairline)
Atlanto-occipital fusion (which is fusion of the first vertebra to the bottom of the skull)
Diagnosis of Congenital Torticollis
A doctor's evaluation
Usually x-rays
To diagnose the defect, doctors do a physical examination. They also do imaging tests, such as x-rays of the bones of the neck and shoulders, to look for problems.
Treatment of Congenital Torticollis
Depends on the cause
Rotating the head and stretching the neck
Sometimes injections of botulinum toxin
Treatment of torticollis caused by neck muscle injury includes rotating the head and stretching the neck. When torticollis is difficult to treat, doctors inject botulinum toxin into the stiffened neck muscle. The injections relax the stiff muscle.
Doctors may do surgery to correct or stabilize injuries and abnormalities of the vertebrae.
Because abnormal genes may be involved in the formation of congenital torticollis, affected families may benefit from genetic counseling.
