Congenital muscle torticollis (CMT), commonly called 'wryneck', is a condition in which the baby's neck muscles are shortened, causing the head to tilt to one side. These are usually present at birth and their life expectancy depends on the underlying cause. CMT usually affects 1 in 10 babies.
Why CMT?
CMT may occur for a number of reasons. Difficult births such as delivering a baby or breech delivery are some of the reasons babies can be born with CMT. Diagnosis is usually made by a pediatric specialist within 2 to 3 months after birth. During delivery if the neck muscles are stretched or injured, fibrosis or scar tissue is developed. This causes the muscles to shorten or tighten and causes the baby's head to lean. Defects in the development of the neck muscles or abnormal fetal position can also cause CMT. CMT is more common in men than women. Studies have shown that 10% of babies with CMT have family members born with CMT.
How is CMT detected?
A pediatrician can detect CMT with the help of x-ray and ultrasound tests. X-rays help detect abnormalities in the neck and shoulders. Usually, x-rays are selected when the cause of CMT is congenital defect in the cervical spine. Some children with CMT may also develop other musculoskeletal problems, and therefore, x-rays of other parts of the body may also be needed. To distinguish CMT from other neck mythologies, ultrasound may be first performed. When a CMT is identified, x-rays and ultrasounds are selected based on the severity of the CMT.
Can CMT be prevented? What treatment will be offered for CMT?
CMT is not preventable but can be treated. Treatment is usually done through medication or muscle training, depending on the severity of the condition. Often parents will be referred to physical therapy to learn what exercise will be used for the baby to exercise muscle. These exercises include rotation and bending of the child's side to stretch the muscles. Most of the time, neck mass can increase during the first month of the baby but gradually decreases and eventually disappears. At times, surgery is also one of the considerations for repairing shortened muscles. Also, the child's age, medical history and parental opinion will be considered before any kind of treatment begins.
What is the effect on treatment?
Most babies, after treatment, have no problems in the future. However, a small number may experience an imbalance in their ability to tilt their head, differences in size and shape on both sides of the neck and at times may be slightly scoliosis. The risk of these complications does not appear to be influenced by the different types of treatment used. However, there is a problem if CMT is not treated. These problems can sometimes lead to long-term problems such as loss of neck movement, non-communicable inflammatory diseases and sometimes, even loss of function in children. While successful surgery is performed on children up to the age of ten, it is best to detect CMT early and treat it.
When should I see my pediatric specialist?
Although CMT symptoms vary from child to child, it is best to consult your pediatrician as you observe your child tilting his head to one side or his chin looking in the opposite direction. After all, the sooner it is detected, the better and more efficient treatment can be done.
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