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Torticollis secondary to ocular pathology
C R Williams1, E O'Flynn, N M Clarke
1Southampton University Hospital, UK.
Summary
Ocular causes are frequently undetected in pediatric torticollis. Prompt ocular assessment is crucial for accurate diagnosis and effective treatment of pediatric torticollis.
Area of Science:
- Pediatric Orthopedics
- Ophthalmology
- Pediatric Neurology
Background:
- Torticollis in children often presents with normal neck range of motion.
- Palpable sternomastoid muscle tightness can occur without true contracture.
Purpose of the Study:
- To investigate the prevalence of ocular causes in pediatric torticollis.
- To determine the necessity of ocular examination in torticollis evaluation.
Main Methods:
- Prospective referral of 15 pediatric torticollis patients for ocular examination.
- Clinical assessment including orthopaedic and ocular evaluations.
- Surgical and non-surgical treatment approaches based on diagnosis.
Main Results:
- Five of 15 children had an identified ocular cause for torticollis.
- Detected ocular issues included superior oblique underaction, lateral rectus paresis, and nystagmus.
- Three patients with ocular torticollis required extraocular muscle surgery; one also had sternomastoid tightness.
Conclusions:
- Ocular assessment is essential for pediatric torticollis cases lacking clear orthopedic findings.
- Clinical examination cannot reliably differentiate ocular from non-ocular torticollis.
- Early ocular evaluation aids in appropriate management and surgical intervention.