Synonyms: torticollis, congenital muscular torticollis English: wry neck, loxia
The torticollis is a general term for a disease that ultimately results in a crooked posture of the head. There are different forms of torticollis, which have different causes and symptoms. A rough classification is made according to whether the torticollis is congenital or acquired.
This article focuses on the clinical picture of congenital muscular torticollis. The congenital muscular torticollis is based on a congenital malformation of a certain muscle and is therefore a disease that often manifests itself already in the newborn. In medical terminology, the congenital muscular torticollis is called congenital muscular torticollis (torticollis).
The congenital muscular torticollis is based on a malformation of the sternocleidomastoid muscle. This muscle lies superficially on the neck and can be easily palpated when the neck is tensed. It has the function of a head turner.
The human body has one such muscle on each side of the neck. When the muscle on one side contracts, i.e. is tensed, the head turns to the opposite side. With pathological constant contraction, the head therefore remains in a forced malposition.
There are now different theories as to what exactly causes the malformation. The following is a list of possible causes:
- Birth trauma: One possible theory is that children who have undergone a long birth with a difficult course are more likely to develop a muscular torticollis. This can lead to excessive stretching of the muscle when the newborn’s head is stretched during the long birth.
Tears in the muscle may occur, which cause it to bleed into the muscle. The bruising causes the muscle to be remodeled. Connective tissue, not muscle tissue, is inserted.
This is called fibrotic change. The result is a shortened, fibrotically altered muscle. However, this is only one theory.
There’s no way to know for sure if it’s actually true. – Genetic predisposition: Another possible cause is a genetic predisposition for the formation of a muscular torticollis. There are families in which children with this malformation are born with a conspicuously high frequency.
- Compartment syndrome: Compartment syndrome is a muscular disease in which important vessels and nerves are compressed (squeezed). The cause is a swelling of the surrounding tissue. If the fetus lies crooked in the birth canal and the head in particular is trapped for a long time in a hyperextension or sideways position, the symptoms are very similar to those of compartment syndrome.
The tissue pressure in the area of the opposite sternocleidomastoid muscle increases and can lead to an undersupply of blood, a so-called ischemia. The injury to the muscle results here from a bruise or buckling and not from a tear (see theory 1). – Pelvic end position: A forced position of the fetus, in which the pelvis precedes the head, rather than the head, can promote the occurrence of a muscular torticollis.