Congenital torticollis and saccular dysfunction: a case report.

Area of Science:

• Pediatric Neurology
• Vestibular System Disorders
• Otolaryngology

Background:

• Congenital muscular torticollis is common in infants.
• Persistent cases may indicate underlying vestibular dysfunction.
• Early diagnosis is crucial for effective intervention.

Observation:

• An 18-month-old infant presented with torticollis, postural imbalance, and rotary nystagmus.
• The infant had undergone prolonged physical therapy without full resolution.
• Vestibular testing revealed abnormal cervical vestibular evoked myogenic potentials (cVEMPs) and positional vertigo.

Findings:

• The infant exhibited left-sided saccular dysfunction, indicated by low-amplitude cVEMP responses.
• Rotary-torsional nystagmus suggested positional vertigo linked to saccular dysfunction.
• This is the first reported case of torticollis attributed to saccular dysfunction.

Implications:

• Saccular dysfunction should be considered in infants with congenital torticollis unresponsive to physical therapy.
• Early detection of saccular dysfunction is vital for appropriate management in pediatric patients.
• Further research is needed to validate these findings and guide clinical practice.