Torticollis or Wry Neck or Loxia: Causes, Symptoms, Diagnosis, Treatment, Prognosis

A lot of times we come across people who say that their babies have a sort of a lump in their neck or some parents feel that their babies are turning their head only to one side. This is due to a medical condition where the muscles in the neck get injured. This is termed as Torticollis. In this article, we will study about the meaning of Torticollis, its causes, symptoms, and what are the treatments in detail. Torticollis is also known by the name of “Wry Neck” or “Loxia.”

How Do We Define Torticollis or Wry Neck or Loxia?

How Do We Define Torticollis or Wry Neck or Loxia?

The term Torticollis comes from a Latin word “tortus” which means “twisted” and collum which means “neck.” The general meaning of Torticollis is a “twisted neck.” There can be numerous causes for Torticollis but the most common cause in children is Muscular Torticollis. In Muscular Torticollis, the neck- muscle gets injured, either before birth, at the time of birth, or afterwards. Any sort of bleeding into the muscle can result in hematoma. The muscle can contract with passage of time as the hematoma is in the healing phase hence pulling the head in one direction.

Who All Are At Risk For Torticollis or Wry Neck or Loxia?

Muscular Torticollis is generally found in large infants and as a result of a difficult delivery. Muscular Torticollis or Wry Neck is also common with breech presentation along with congenital hip dislocations. Children who have Torticollis later in childhood need to be carefully monitored. Quite a few of such children have torticollis as a result of minor trauma to the neck muscles or as a result of upper respiratory viruses. In some cases, Torticollis can develop as a result of a potentially serious issue like a tumor.

Causes Of Torticollis or Wry Neck or Loxia

There may be many causes for Torticollis or Wry Neck to develop, some of them are:

  • Inherited – As a result of changes in genes.
  • Acquired – Development of Torticollis due to injury to nervous system, upper part of spine or muscles.

If there is development of Torticollis without any known cause then it is termed as Idiopathic Torticollis.

Torticollis can develop both in childhood as well as adulthood. In case, if the baby’s head was in the wrong position in the womb of the mother, then that baby may develop Congenital Torticollis.

Symptoms Of Torticollis or Wry Neck or Loxia

Some Symptoms Of Torticollis or Wry Neck or Loxia Are:

  • Reduced range of motion of head
  • Headaches
  • Tremors of head
  • Neck pains
  • Unleveled shoulders
  • Neck muscle stiffness
  • Swelling of neck muscles, probably at birth.

Diagnosis Of Torticollis or Wry Neck or Loxia

There are many investigations that can confirm the presence of Torticollis, but other causes of head and neck pain needs to be ruled out. In the case of torticollis, the physical examination may show:

  • Head tilted toward one side while the chin pointing to the opposite side
  • Shortening of neck muscle
  • Head turning to one side, this is generally in more severe cases of Torticollis.

Other Tests That Can Be Done Are:

  • CT scan of neck
  • EMG to look into the muscles which are maximally affected
  • MRI of brain

Treatment For Torticollis or Wry Neck or Loxia

Torticollis which is present at the time of birth can be treated by stretching the neck muscles that are short. It is done by passive stretching and positioning in babies. These treatments have often been found to be successful, particularly when they started as early as within four months of age. In case these modalities are not successful to treat Torticollis, then surgery can be done to correct this. Torticollis as a result of some sort of injury to the nervous system, spine, etc. can be treated by treating the underlying cause. Massaging can also be done to help with the neck and head pain. Neck braces can also be used for muscle spasms as a result of Torticollis. Baclofen has also been found to be helpful for Torticollis.

Prognosis Of Torticollis or Wry Neck or Loxia

Torticollis is generally easier to treat when it develops in children. If Torticollis gets to the chronic stage, there may be development of numbness and tingling as a result of pressure on nerve roots in neck.

When To Seek Medical Advice For Torticollis or Wry Neck or Loxia?

If the treatment modalities discussed above do not help in treating the condition or new symptoms start to develop, then medical attention needs to be sought. Immediate medical attention needs to be sought in case of Torticollis or Wry Neck is developed after some sort of injury or some other illness.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:February 2, 2019

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