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Torticollis and vestibular concerns in an infant

Printed From: CyberPT - Your Online Physical Therapy Resource
Category: Specialty Forum for PTs/Healthcare Professionals
Forum Name: Pediatrics
Forum Description: Discussion on Pediatrics
URL: http://www.cyberpt.com/ptforum/forum_posts.asp?TID=338
Printed Date: Dec 09 2024 at 6:43am
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Topic: Torticollis and vestibular concerns in an infant
Posted By: Ask a PT
Subject: Torticollis and vestibular concerns in an infant
Date Posted: Dec 15 2008 at 1:32pm
Our user asked: "I am working with a toddler who has has full range of motion in his neck, but his preferred head position is in L lateral flexion and rotation to the R. I am sure it is vestibular in origin and that that is how he is righting himself. Any treatment options or ways to "fix" this so that he doesn't get get muscular torticollis. I have the basic information and am still looking for more info in my texts and online...Thanks!"
 
Ask a PT Response: "I was just wondering is you could give more details as to why you are suspecting a vestibular dysfunction. Are you seeing abnormalities with VOR, tracking etc..."
 
Our user responded: "He is deaf.  I feel I can't ask too many questions on his listserve for the fear that mom may find me and see me as an inadequate therapist.  I have been commended on wanting to find more literature and on how nice it is that I am searching for new info.  The child is deaf with some visual deficits (far sighted and he JUST went to the eye doctor yesterday and got a pretty good bill of health otherwise).  His resting position is for him to sit and tilt that head.  We can coax him to turn to the left and tilt upward to look for people or a toy.  He tracks, but easily loses interest when something is at the far end of his field.  If he is standing at funrtire, he will not waste the energy to try and turn AND keep his balance.  If he is sitting, he will pivot or transfers onto all fours to see.  When I palpate is little neck, he doesn't really seem to be muscularly restricted-Help!"
 
Ask a PT Response: "Does the child display distress when he turns his head to the other direction? Also when you perform tests such as sidelying test or Hallpike-Dix does the child display nystagmus or distress with the tests? Also have you done any balance testing. You will have a better understanding of his condition if you do the forementioned testing. One thing that I would be interested in knowing is if the hearing loss of both ears are equal. If he is able to achieve better hearing in one ear, he might turn his head towards the better side in order to obtain more acoustic stimuli. Good luck!"



Replies:
Posted By: Mary
Date Posted: Feb 22 2009 at 6:49am
Have the child's vision checked.  Often kids will have head tilts with visual deficits.  Also, have you check for plagiocephaly.  Karen Karmel Ross book and course are very helpful.  Cranialtech.com is also helpful.


Posted By: Ask a PT
Date Posted: Feb 22 2009 at 11:54am
Thanks for the additional insight Mary! Checked out http://www.cranialtech.com - www.cranialtech.com  and it was very informative. Thank you!!


Posted By: chickoo
Date Posted: Jan 11 2012 at 1:44am
Pediatrics is a relatively new medical specialty.Pediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents.

http://www.drlevinehospital.com/ - Hospitals in Bellandur



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