| Torticollis is defined by head tilt toward the contractured
muscle and chin rotation to the opposite
direction, and can lead to secondary problems
such as plagiocephaly, scoliosis, delayed cognitive
development and impaired balance [Cooperman,
1997]. Torticollises are a common cause of referral
to rehabilitation clinics in the pediatric setting.
The etiologies of torticollis may be orthopedic,
neurologic or ocular. Congenital muscular torticollis
due to sternocleidomastoid contracture is
the most common type in infants and may be
treated with conservative treatment such as
muscle stretching. Surgery is recommended in
congenital muscular torticollis if conservative
treatment is ineffective or if it results in progressive
maxillofacial asymmetry [Suhr and Oledzka,
2015]. Other causes are ocular torticollis due to
ocular muscle weakness, Sandifer’s syndrome
due to gastroesophageal reflux, neural axis abnormalities
and benign paroxysmal torticollis. Ocular
torticollis usually occurs due to different ophthalmic
conditions, including paralytic and restrictive
disorders of ocular movement, nystagmus and
defects of the visual field [Herman, 2006]. Here
we report a missed ocular torticollis in a girl with
presumed congenital muscular torticollis. |