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['Cases against KiSS': a diagnostic algorithm for children with torticollis]
C Happle1, M Wetzke, E J Hermann
1Medizinische Hochschule Hannover, Kinderheilkunde, Hannover. happle.christine@mh-hannover.de
Klinische Padiatrie
|December 17, 2009
Summary
Kinetic imbalance due to suboccipital strain (KiSS-syndrome) lacks scientific evidence. Misdiagnosis of infant torticollis as KiSS-syndrome can delay crucial brain tumor diagnosis and treatment.
Area of Science:
- Pediatrics
- Neurology
- Manual Therapy
Background:
- The concept of kinetic imbalance due to suboccipital strain (KiSS-syndrome) proposes a functional abnormality in the infant's upper cervical spine causing head-positional preference.
- Manual therapy is often recommended for KiSS-syndrome, despite reported severe side effects.
Observation:
- Two infants presenting with torticollis and neurological symptoms like ataxia were initially misdiagnosed with KiSS-syndrome.
- These symptoms were later identified as resulting from brain tumors, leading to significant diagnostic and therapeutic delays.
Findings:
- There is a lack of scientific evidence supporting KiSS-syndrome as a distinct clinical entity or the efficacy of manual therapy for its treatment.
- While positional head preference and body asymmetry are common in infants, serious differential diagnoses, including brain tumors, must be considered for torticollis.
Implications:
- This case highlights the critical importance of comprehensive differential diagnosis in infants with torticollis to avoid overlooking serious underlying conditions.
- Accurate diagnosis is essential to prevent delays in appropriate medical intervention and improve patient outcomes.
