▲ Figure 1: left stiff neck, head tilted to the left side of the face to look at the right side, the left side of the face, eyes and chin are smaller. (Photo provided by Li Dongzhou)
Text / Li Dongzhou
▲Figure 3: Ultrasound shows muscle mass in the torticollis. (Photo provided by Li Dongzhou)
When you notice your baby tilting his head to look at you, don’t think it’s cute, because your baby may have a stiff neck (Figure 1). Congenital torticollis is a contracture or fibrosis of the sternocleidomastoid muscle on one side that causes a baby to be noticed shortly after birth with his head turned to one side all day and with the other ear pressed against the shoulder. If it can be treated early, the prognosis will be excellent. If it is treated too late, the baby may have a crooked face, an abnormal head shape and other complications, which may require surgical treatment. Therefore, parents are reminded of the following points to avoid regrets in the future.
▲Picture 2: Stiff neck lying on one side, the back of the head becomes flat, and the face protrudes slightly. (Photo provided by Li Dongzhou)
Early diagnosis, diagnosis, early treatment and excellent prognosis
● Early detection and diagnosis: In addition to turning the head to one side and leaning to the other, if the child has a flat back of the head (Figure 2) or an asymmetrical left and right face, the risk of torticollis increases by 23 e 22 times, respectively. Once you have any doubts, you should take him to a rehabilitation department or a pediatrician as soon as possible, the doctor will confirm the diagnosis and judge the severity according to the type of posture, type of muscle or type of mass (Figure 3 ).
●Early rehabilitation: Babies before 2 months have weak muscles, and the neck can be easily stretched and rehabilitated. If rehabilitation is started before 1 month of age, 1.5 months are enough and 98% of them recover well; if treatment is started at 1-3 months of age, it takes 6 months for rehabilitation, but only 89% of them recover well; 3-6 months For those seeking medical care, they need to recover for 7.2 months, and the remaining 62% recover well, and 25% need surgery; if they are delayed to 6-12 months, only 19% recover well after 9 months of rehabilitation and 70% need surgery.
● Don’t ask the cause: the cause of the torticollis is still unknown. Although many theories have been proposed, no root cause has been confirmed and it is not a genetic disorder. Therefore, parents should not spend too much time exploring the cause.
Cooperate with home rehabilitation: The focus of rehabilitation is not in the hospital but at home. The therapist will guide parents to do passive neck stretching exercises for the child, promote active movements of the neck and trunk, develop symmetrical movements, and guide different situations (lying, lying down) and breastfeeding, etc.) parental positioning and education. With the consent of the therapist, remember to take a photo of the rehabilitation method with your mobile phone, and you can only do it correctly when you get home.
Studies have confirmed that the more home rehabilitation, the faster the improvement. Parents can take more pictures of their babies to see improvements in head rotation, head tilt and facial asymmetry. If there is no improvement or progress stops after 4 to 6 weeks of rehabilitation, a new treatment plan should be discussed with your doctor.
Monitor movement cognition carefully to aid medical diagnosis and treatment
●Check the children’s health manual: a small number of torticollis is not caused by sternocleidomastoid muscle disease, often combined with developmental delay, so parents carefully monitor the development of movements, cognition, speech or interpersonal interaction in the children’s health manual will help remind doctors Sonda further. Torticollis is often associated with hip dysplasia (up to 20%), metatarsal adduction, equinus, and brachial plexus palsy, which also affect motor development. Fortunately, studies have found that babies with simple torticollis who are developmentally delayed at 2-6 months can catch up on development of the same age at 8-15 months.
(The author is an attending physician in the rehabilitation department of Cathay Pacific Hospital)
☆ Health news never fails, the press loves to keep trackfan page。
☆For more important medical news, go toFreedom Health Network。
No need to smoke, no rush, now use the APP to watch the news and guarantee to win the lottery every dayClick me to download the APP
According to how I see the activities
