It may be due to defects in the ability of brain to process chemical messages which help the brain cells to comunicate to each other.
Congenital muscular torticollis The cause for a congenital torticollis is unclear, however, some of the possible causes cited may be:-
Inherited genetic defect.
Intrauterine malposition or trauma at birth wherein there is an injury to a neck muscle (sternocleidomastoid) leading to a restricted range of motion in rotation as well as lateral bending due to shortened or excessively contracted neck (sternocleidomastoid) muscle. The head gets tilted at an angle and the chin turns to the opposite side.
Tumor in the affected muscle. This may happen at the age of two to four weeks and slowly goes away. The muscle may become fibrotic but this may also disappear in initial five to eight months of life.
Acquired torticollis This is due to injury to muscles or nerves. It is due to injury to neck, tumor at the base of the skull, a specific type of surgery for ear infection, nerve irritation due to infection of the posterior part of the pharynx and certain antipsychotic drugs.
Age group between 40 to 60 years, being women and family history of cervical distonia are the risk factors for wryneck.
Symptoms of wryneck are neck pain, headache, limited range of motion, head tremor, one shoulder is higher, chin straight up or down, chin or ear towards shoulder, swelling or stiffness of the neck muscle.
Diagnosis of wryneck is done on the basis of history of birth, injuries, physical examination, neurological examination, examination of associated conditions, X-ray, electromyography, MRI (Magnetic resonance imaging) and blood or urine tests (for presence of toxins). Ophthalmological examination is also required to check for any vision problems.
The condition may be treated by physical therapy or surgery. Physical therapy includes stretching, strengthening exercises and handling to encourage symmetry.
Changing the position in supine position is helpful. Giving plenty of tummy time when awake is also helpful.
Other treatments are low impact exercise, extended heat application, chiropractic correction of neck or repetitive shiatsu massage. If all methods of treatment fail then surgery can be done.
Acquired muscular torticollis
Traction or surgeries are the treatment options depending on the cause of acquired torticollis.
Medications used for the treatment of wryneck are drugs for tremor control, muscle relaxants or botulinum toxin.
Deep brain stimulation is also a treatment modality used for the treatment of cervical distonia.
Taking rest and reducing stress can help in minimizing the effects of cervical distonia.
The condition is easy to treat in infants and children. If the condition becomes chronic then there may be tingling or numbness due to compression of the nerve roots. Botulinum toxin gives relief.
Infants with wryneck are at increased risk of plagiocephaly (flattening of one side of the skull). There may be muscle swelling or compression of nerve root and neurological symptoms or depression.
