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Merck Manual

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Congenital Torticollis


Simeon A. Boyadjiev Boyd

, MD, University of California, Davis

Last full review/revision May 2020| Content last modified May 2020
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Congenital torticollis is a birth defect in which the head becomes tilted at or soon after birth.

The most common cause of congenital torticollis is

  • Injury to the baby's neck during delivery

Torticollis that develops within the first few days or weeks of life may result from

  • A hematoma (which is a collection of blood) in the neck muscles

  • Fibrosis (which is an abnormal thickening of tissue)

  • Contracture (stiffening) of the sternocleidomastoid muscle (one of the neck muscles)

  • Klippel-Feil syndrome (fusion of the vertebrae in the neck, a short neck, and a low hairline)

  • Atlanto-occipital fusion (which is fusion of the first vertebra to the bottom of the skull)

To diagnose the defect, doctors do a physical examination. They may also do imaging tests to look for problems with the bones.

When torticollis is due to a birth injury, treatment includes rotating the head and stretching the neck. When torticollis is difficult to treat, doctors inject botulinum toxin into the stiffened neck muscle. The injections relax the stiff muscle.

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