Symptoms of torticollis in a newborn can appear immediately after birth, if the pathology is innate. Also, the first symptoms can appear within three weeks after the birth of the child. Sometimes a doctor can not always see the symptoms of torticollis in a newborn, then the first person who can notice the clinic of this pathology can be a mother. The most visible symptom is the inclination of the child's head to the sore side. And, accordingly, right-sided or left-sided torticollis of newborns will lead to tilting the head in one or the other direction. Given that the newborn's neck is short enough and this feature is not always visible, then you can see that the child, when lying always turns the head to the side. In this case, the eyes and lobes of his ears are not on the same level. This may be the first signs of torticollis in the baby. Over time, one can see the asymmetry of the face of the baby and the muscles on one side can be strained. The newborn, who has large enough cheeks, is easy to notice.
Often when the baby is bathing, the mother may notice a symptom of the thickening of the affected muscle. This can be when the mother is doing massage to the baby, she may notice that one muscle is strained or it is slightly shorter than the other. This may be one of the symptoms that require further diagnosis.
Congenital torticollis in newborns is also represented by other diseases: Klippel-Feil syndrome, Sprengel's disease, and cervical ribs. All these types of torticollis are congenital in nature, manifested in the first month of life and are characterized by the curvature of the neck.
The Klippel-Feil syndrome is a congenital hereditary disease that has an autosomal dominant type of inheritance. The classic manifestations of this disease are:
- a short neck in the child, which is quite easy to see precisely because of the severity of this symptom - after all, the chin can sometimes touch even the shoulder line;
- the hair growth line behind is very low;
- with the rotation of the head there is a pronounced restriction of turns to the side.
Shortening of the neck is usually detected at birth, which directly indicates the diagnosis of torticollis. But sometimes this symptom can not be noticed, and when the child grows, you can see how the whole of his skeleton is changing. At the same time, the thorax is shortened and the lower aperture widens. The shoulders are located at different levels and the scapula are very small. Children can not turn their heads, so they respond to any stimuli only by turning their eyes. Further with age, the following symptom, which the mother may notice - the child does not hold his head, when he already has to do it.
Sprengel's disease is a congenital high standing of the scapula. The pathology arises sporadically, due to the delay in the development of the scapula and the lowering of the 3-4th week of embryonic development. It is characterized by the following main features:
- A marked asymmetry of the contours of the neck (on the side of the high standing of the scapula, the contour of the neck is flattened).
- Restriction of movements in the cervical spine and in the shoulder joint on the side of the lesion.
- High position of the blade (6-12 cm higher than in the opposite scapula).
- Reduction of the size of the scapula.
- Rotation of the scapula around the sagittal axis.
- Atrophy of the muscles of the shoulder, shoulder on the side of the lesion.
- Reduction of the mobility of the scapula, especially with bone fusion.
All these symptoms arise precisely because of the small size of the scapula, so the torticollis is already considered a secondary symptom.
Acquired torticollis in newborns develops after birth. The cause of it may be a bacterial infection or a disease of other organs. And accordingly, different types of torticollis are distinguished:
- Myogenic (due to muscle damage). This can occur with inflammation of the nodding muscle, the tumor of this muscle.
- Bone - develops with congenital fractures or dislocations of the vertebrae, as well as in rickets, spondylitis.
- Neurogenic (with pathologies of the nervous system). In children with congenital infantile paralysis with violation of innervation of the muscles and their paralysis or paresis.
- Desmo - dermatogenic (with pathology of the skin and ligamentous apparatus). This kind of torticollis can develop with large skin scars, which can pull on the muscles, as well as with eye disease, as a compensatory mechanism.
The most common form of acquired torticollis, which can be in newborns is the so-called Grisell's disease. It is characterized by the appearance of curvature of the neck against the background of inflammatory processes between the I-II cervical vertebrae.
The cause of such torticollis are the inflammatory processes of the nasopharynx, the ears. In newborns, a long undiagnosed otitis can quickly lead to a zygomatic abscess, which leads to contracture of the muscles near the cervical spine. First, the child's body temperature rises, which indicates an acute inflammatory disease of the nasopharynx or ear. The nerve muscle on the side of the torticollis is not tense, not shortened. Then the child tilts his head in one direction, which can be noticed after some time after the symptoms of hyperthermia.
Setting or positional torticollis in newborns is considered one of the simplest variants of the disease. It develops throughout the first month of life, when the child is lying in the wrong bed. This can lead to the fact that the muscles on one side can be strained, while on the other hand they are relaxed. This happens if the child sleeps incorrectly or all the time turns to sound or light and lies in this position. When the baby starts to hold the head, then the muscles are more developed on one side and the neck is curved in this direction.