KISS syndrome is a clinical picture in the field of pediatrics (children’s medicine) and describes a series of disorders related to the child’s upper cervical joint or cervical spine. The term “KISS” is an acronym for Kinetic imbalance due to suboccipital strain. The syndrome was defined by the surgeon and manual therapist Heiner Biedermann. A symptomatology that corresponds to the KISS syndrome but occurs in school children is called upper cervical dyspraxia and dysgnosia (KIDD syndrome). These children are conspicuous for lack of concentration and performance and learning difficulties. The basis for the genesis of the KISS syndrome is the assumption that disturbed posture as well as behavioral disorders in infancy and toddlerhood are due to a symptom complex that is related to the birth process and certain risk factors. These risk factors include:
- Cervical spine trauma (injury to the cervical spine) during childbirth – e.g., from extraction devices (birth forceps)
- Intrauterine position anomalies (unfavorable position of the child in the uterus) – e.g., pelvic end presentation.
- Prolonged pressure contractions
- Multiple pregnancies (e.g. twins).
- Fall in early childhood
- Rapid course of birth
- Sectio caesarea (cesarean section)
According to Biedermann, affected KISS children are noticeable by an asymmetrical posture, a fixed one-sided sleeping position and sensitivity to touch in the area of the neck. According to Biedermann, there is often a side preference with regard to motor function. A distortion (strain) and subluxation (incomplete joint dislocation) in the atlantoaxial joint (joint between the first cervical vertebra (atlas) and the second cervical vertebra (axis); “head joint”) is postulated as the causative factor. The following symptoms, also referred to as postural asymmetries, are united in the diagnosis of KISS syndrome:
- Facial asymmetry
- Gluteal fold asymmetry (buttress asymmetry).
- Temporomandibular joint asymmetry
- Ophistotonic posture (increased tone of the extensor muscles of the back, especially the cervical spine, resulting in a posture that is strongly tilted backwards).
- Infant scoliosis (non-physiological bending of the spine to the side).
- Deformities of the skull
- Torticollis (crookedness of the head)
Furthermore, the following symptoms are associated with KISS syndrome:
- Arm plexus paralysis (paralysis of the brachial plexus).
- Fever
- Foot malpositions – e.g. sickle foot
- Hip dysplasia (hip maturation disorder).
- Colic (crampy abdominal pain)
- Muscular hyper- or hypotonia (increased or decreased muscle tension).
- Strabismus (squint)
According to Biedermann, the symptoms described initially appear as a functional disorder, but can manifest morphologically if not treated. Consequences that mainly affect the child’s behavior and lead to disorders are:
- Motor developmental delay
- Screaming tendency
- Sleep disorders
- Drinking difficulties or breastfeeding difficulties
KISS syndrome appears as a multifaceted clinical picture. The above symptoms occur frequently, so that many infants with only minor abnormalities can be attributed to this diagnosis. Furthermore, asymmetries regress spontaneously in the first months of life and thus do not require treatment. The evidence of this disease or the need for treatment is not recognized by conventional medicine. According to Biedermann, the KISS syndrome can be treated mainly with manual therapy methods. A number of methods are mentioned, which are summarized in the following. The aim of the therapy methods is to give the child a corrective impulse.
Therapy methods
- Atlas therapy according to Arlen – Atlas therapy according to Arlen is a gentle, manual procedure, which is assigned to manual medicine. It involves a reflex and regulatory influence on the autonomic and peripheral nervous system through a gentle manual impulse technique on the transverse processes of the first cervical vertebra (synonyms: atlas; C1).
- Dorn therapy – Dorn therapy is a complementary medicine manual method, which is related to chiropractic and also includes elements of Traditional Chinese Medicine (TCM).
- Craniosacral therapy – Craniosacral therapy (synonyms: craniosacral therapy; craniosacral therapy; CST) is a form of treatment derived from W. G. Sutherland’s craniosacral osteopathy (1930) and belongs to the field of manual medicine. The basis of craniosacral therapy is the craniosacral system, which is characterized by the functional unity of the cranium (bony skull) and sacrum (sacrum).
- Manual Therapy – Manual therapy (Latin manus: “hand”) is a form of therapy in which the therapist works exclusively with his hands (manual therapy; manual therapy). It mainly treats pain in the back, joints or muscles. It is based on the assumption that displacement of vertebrae from their physiological (normal) position can lead to irritation of the nervous system. In case of such irritation of the nervous system, it is also called blockage of the spine. With the help of manual therapy, these blockages are solved and the symptom thus treated.
- Myoreflex therapy – Myoreflex therapy is a therapeutic procedure for the treatment of increased basic tension of the skeletal muscles, which is associated with a load on both the surrounding soft tissue structure and the joints. By creating so-called conversion stimuli, the body is moved through a balance production to regenerate the musculoskeletal system.
- Osteopathy – Osteopathy is a predominantly manual diagnostic and therapeutic concept that goes back to the U.S. physician Andrew Taylor Still (1828-1917). It refers to the diagnosis and therapy of dysfunctions of any kind, according to Still, disorders and movement restrictions of the fascia and joints can also trigger symptoms in other organs and body regions.
- Therapy according to Vojta – The Vojta concept was developed in the 50s by the neurologist and neuropediatrician Dr. Vaclav Vojta (1907-2000) and is used in neurological, neuropediatric as well as neuroorthopedic clinical pictures. The principle consists of the so-called reflex locomotion (reflex locomotion), thereby elementary movement patterns in damaged central nervous system and musculoskeletal system are made accessible again for the patient.
- Therapy according to Castillo-Morales – The therapy according to Castillo-Morales is a holistic therapy concept, the basis of which is the knowledge of neuromotor development. Both children and adults suffering from neurological disorders are treated. Furthermore, the so-called orofacial regulation therapy is a treatment focus of this concept: Here, an improvement in communication and food intake is the goal of the intervention.
- Therapy according to Bobath – The Bobath concept (synonym: Neurodevelopmental Treatment – NDT) is a concept that is used both in physiotherapy and in occupational and speech therapy for the treatment of patients with a cerebral movement disorder (CP, eg after stroke) regardless of age.
- Therapy according to Feldenkrais – The method according to Feldenkrais is a movement therapy that focuses on a change in perception regarding unconscious movement sequences. By making conscious automated, unconscious movement sequences, these are made accessible to the therapy and thus changeable.