Torticollis & Plagiocephaly Flashcards
Torticollis definition
“Wry neck.” Consistent asymmetrical head positioning in an infant or child. Commonly a lateral tilt with rotation to the opposite side. Defined by the direct of the lateral flexion
Plagiocephaly definition
“Oblique head.” Asymmetrical alignment of the cranial bones
Torticollis subgroups
Sternocleido mastoid tumor torticollis (43% - most common); has fibrous mass that's palpable Muscular torticollis (31%); no tumor with limitations in cervical range Positional torticollis (22%); no tumor or range restriction, alignment
Risk factors for torticollis
Prenatally:
First pregnancy
Male
Multiple gestations
Peri/postnatally: Prematurity Assisted delivery Positioning preference Cumulative exposure to supine positioning Orthopedic or neurological dysfunction
What is the most important treatment for torticollis and plagiocephaly?
Prevention and awareness
Types of plagiocephaly
Positional or deformational plagiocephaly
Craniosystosis
Rare congenital condition that causes one or more sutures on a babies head to close earlier than normal
Differential diagnosis head shape
Cranio = asymm. trapezoidal Plagio = asymm. parallelogram
Differential diagnosis result from
Cranio = internal events Plagio = external molding pressures
Differential diagnosis cranial sutures
Cranio = premature fusion Plagio = normal
Differential diagnosis
Cranio = x-rays, CT scan Plagio = clinical
Differential diagnosis treatment
Cranio = surgical correction Plagio = PT repositioning, manual, cranial remolding helmet
Cranial Anthropometric measures
Cranial length/width
Cephalic index
Cranial vault symmetry (X on top of childs head, 3-4 mm difference is ok, we want under 3)
Head circumference
Ohman’s Motor Function Scale
0 = Head below horizontal 1 = Head in horizontal 2 = Head slightly over horizontal 3 = Head high over horizontal 4 = Head very high over horizontal
Cranial asymmetry
We want < 3 mm
