Hey @rachel, sorry to nerd out so deeply here, but I just noticed when I was reading that torticollis is broadly classified as dystonia, or as this article calls it “a dystonic movement”…even in the case of congenital muscular torticollis. But, I hear you differentiating between a soft tissue issue and a CNS issue.
Would you agree with how this wikipedia article explains and categorizes torticollis?
Ha! Sorry to rely so heavily on your expertise! This condition has really sparked my interest- like you said we seem to need way more clinical supports for therapists in this area! This whole conversation is making me want to do a podcast on this topic, because it feels so interconnected to so many things we do!!
This whole subject is just fascinating! I too have started at times using a metronome with some of my ASD students while we complete tasks - it’s very interesting to see how it sometimes helps them to focus, stop verbal stemming and sometimes even speed up or slow down their work.
We’re on the nerd-train now and I love it!!!
No, I don’t agree with that intro sentence of the Wikipedia article. The rest of the article I find valuable and accurate. I take issue with the intro section broadly categorizing Tort as a dystonic condition. The following sentence “The most common case has no obvious cause, and the pain and difficulty with turning the head usually goes away after a few days, even without treatment” describe Smasmodic Tort, not Torticollis as an overarching diagnosis. We can think of Torticollis across the lifespan as a clinical presentation with many underlying causes (most of which can be determined, most are not painful (Tort in babies is rarely painful) and those with dystonia/neurological causes do not resolve on their own in days.
I thought this description was more accurate and may clarify:
“Whether trauma to the neck could cause cervical dystonia remains controversial. Cervical dystonia is a neurological disorder. However, there are some non-neurological conditions that may mimic cervical dystonia… Some infants are born with a shortening of one of the muscles in the neck (congenital infantile torticollis) that causes a head turn. In some children with esophageal reflux, there can also be posturing of the head. There are additional conditions, including functional movement disorders that may appear similar to cervical dystonia but are non-neurologic in origin.” NORD - National Org For Rare Disorders
Worth mentioning, however, is that Sandifer Syndrome which we see most often in babies with GERD/reflux IS characterized as a dystonia (that was new to me but it makes sense as there isn’t an underlying soft tissue root cause). Sandifer Syndrome is definitely worth being aware of for anyone working in Early Intervention as it can red flag a kiddo who may have undiagnosed reflux.
as it can red flag a kiddo who may have undiagnosed reflux.