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The Prevalence of Nonmuscular Causes of Torticollis in Children

Ballock, R. Tracy M.D.; Song, Kit M. M.D.

Journal of Pediatric Orthopaedics: July-August 1996 - Volume 16 - Issue 4 - p 500-504

Summary Torticollis in children may result from a wide variety of pathologic processes. We retrospectively analyzed 288 patients seen in a tertiary care pediatric orthopedic facility for the evaluation of torticollis over a 10-year period to ascertain the frequency of nonmuscular causes of this condition. Fifty-three of these children (18.4% of the study population) had a nonmuscular etiology for their torticollis. Of these 53 patients, Klippel-Feil anomalies were present in 16 (30%), and an underlying neurologic disorder was present in 27 (51%). These neurologic conditions included ocular disorders in 12 (23%) patients, brachial plexus palsies in nine (17%) patients, and lesion involving the central nervous system in six (11%) patients. We conclude that nonmuscular causes of torticollis are collectively not rare. In a child without an identifiable muscular etiology for torticollis, Klippel-Feil anomalies or an underlying neurologic disorder is likely to be the cause of the deformity in the majority of patients.

Study conducted at Texas Scottish Rite Hospital for Children, Dallas, Texas, U.S.A.

From the Department of Pediatric Orthopedics and Scoliosis Surgery, Texas Scottish Rite Hospital for Children, Dallas, Texas, U.S.A.

Address correspondence and reprint requests to Dr. R. T. Ballock, Department of Orthopaedics, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, U.S.A.

© Lippincott-Raven Publishers.