Congenital Torticollis (Twisted Neck)

Congenital torticollis  (Twisted Neck), common in firstborn children, is typically diagnosed 6-8 weeks after birth. Children with a twisted neck are 10-20% more likely to have hip dysplasia (dislocation) at birth as well. The simple act of sleeping may reveal the presence of twisted neck. When a physician suspects congenital torticollis, he or she should also examine the hips. Children with congenital torticollis (or “wryneck”) appear to have their heads tilted to one side. This twisted neck also makes it difficult to turn the head to the opposite side.  

The Causes of Congenital Torticollis

A medical examination may be necessary if, in the first month after birth, your baby has a twisted neck or favors one side. The doctor may find a soft, non-tender mass or “tumor” attached to the muscles on the neck’s tilted side. Congenital torticollis masses usually shrink and often they are completely gone once the child is between 4 and 6 months old.

With firstborn children, there is a greater chance of mothers suffering injuries called intrauterine “packing.” This involves the baby being unable to move around enough inside the uterus, causing muscles to become “stuck” in one position. This packing results in a twisted neck or a dislocated hip. Physical examinations, X-rays, and/or ultrasounds are used to diagnose congenital torticollis. Congenital torticollis tumors may also form and the muscles’ level of tightness depends on the amount of scarring.

Recognizing the Symptoms of Congenital Torticollis

Congenital torticollis causes the head to tilt in one direction with the chin pointing toward the opposite shoulder. In about 75% of all twisted neck cases, the baby favors the right side. In addition to forming a soft, non-tender mass in the neck’s muscles, affected babies also experience a limited range of motion in their necks.

Congenital torticollis also often results in one side of the baby’s face and head becoming flattened because the child always sleeps on one side. This may be relieved by changing the baby’s head position while sleeping, using pillows.

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