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Torticollis in children: an alert symptom not to be turned away

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Abstract

Purpose

The aim of this study is to investigate the spectrum of underlying disease in children with torticollis.

Methods

We investigated the spectrum of underlying disease and to evaluate the clinical features of the children presented with torticollis in the last 2 years.

Results

Of the 20 children (13 girls and 7 boys with the mean age of 8 years, ranging 2 months–12 years), eight of them have craniospinal pathologies (cerebellar tumors in three, exophytic brain stem glioma, eosinophilic granuloma of C2 vertebra, neuroenteric cyst of the spinal cord, Chiari type 3 malformation, arachnoid cysts causing brainstem compression, and cerebellar empyema), followed by osseous origin in five (congenital vertebral anomalies including hemivertebrae, blocked vertebra, and segmentation anomalies), two muscular torticollis (soft tissue inflammation due to subclavian artery catheterization, myositis ossificans with sternocleidomastoid muscle atrophy), and ocular (congenital cataract and microphthalmia), Sandifer syndrome, paroxysmal torticollis, retropharyngeal abscess each in one patients were detected. Ten patients underwent surgery; two patients received medical therapy for reflux and benign paroxysmal torticollis; and one patient with torticollis due to muscle spasm and soft tissue inflammation was treated with physiotherapy.

Conclusions

Various underlying disorders from relatively benign to life-threatening conditions may present with torticollis. The first step should be always a careful and complete physical examination, which must include all systems. Imaging must be performed for ruling out underlying life-threatening diseases in children with torticollis, particularly, if acquired neurological symptoms exist. Besides craniospinal tumors, ophthalmological problems and central nervous system infections should also be kept in mind. Moreover, early diagnosis of these disorders will reduce mortality and morbidity. Therefore, alertness of clinicians in pediatric and pediatric neurosurgery practice must be increased about this alert symptom.

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Conflict of interest

The author(s) declare that they have no competing interests.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Neurosurgery, Erciyes University, Kayseri, Turkey

    Abdulfettah Tumturk & Ali Kurtsoy

  2. Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Erciyes University, 38039, Talas, Kayseri, Turkey

    Guldemet Kaya Ozcora, Ayse Kacar Bayram, Mehmet Canpolat, Hakan Gumus, Sefer Kumandas & Huseyin Per

  3. Department of Pediatric Surgery, Kayseri Education and Training Hospital, Kayseri, Turkey

    Murat Kabaklioglu

  4. Faculty of Medicine, Department of Radiology, Division of Pediatric Radiology, Erciyes University, Kayseri, Turkey

    Selim Doganay

  5. Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology & Oncology, Erciyes University, 38039, Talas, Kayseri, Turkey

    Ekrem Unal

Authors
  1. Abdulfettah Tumturk
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  2. Guldemet Kaya Ozcora
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  3. Ayse Kacar Bayram
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  4. Murat Kabaklioglu
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  5. Selim Doganay
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  6. Mehmet Canpolat
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  7. Hakan Gumus
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  8. Sefer Kumandas
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  9. Ekrem Unal
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  10. Ali Kurtsoy
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  11. Huseyin Per
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Corresponding authors

Correspondence to Ekrem Unal or Huseyin Per.

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Tumturk, A., Kaya Ozcora, G., Kacar Bayram, A. et al. Torticollis in children: an alert symptom not to be turned away. Childs Nerv Syst 31, 1461–1470 (2015). https://doi.org/10.1007/s00381-015-2764-9

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  • DOI: https://doi.org/10.1007/s00381-015-2764-9

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