Wryneck

Wryneck - strain neck, various clinic, etiology and pathogenesis, uniting leading symptom - incorrect position of the head. There are congenital and acquired Krivoshey.

wryneck
Wryneck: 1 - congenital muscular (left); 2 - spastic.

Congenital forms Krivoshei. Gipoplasticheskaya congenital muscular torticollis occurs most frequently. Due to the length of one of the sternoclavicular-sokovyh (rarely two) muscles (due to its congenital underdevelopment and subsequent changes) and cervical spine.
The clinical picture. In children late in the second - the beginning of the third week of life is average or middle-lower part of the sternoclavicular-liners muscle thickens and becomes denser, there is an inclination of the head towards the affected muscle. Less pronounced asymmetry of the face and skull, the difference in shape, position and size of the ears, the lack of horizontal wrinkles on the neck, and so on, some patients for 2-12 months thickening decreases and disappears, sternoclavicular-nipple muscle becomes a normal elasticity and all the signs of strain disappear. In other patients, muscle is more than a short, thin and thick, which entails the development Krivoshei. With age, tilt, swivel and asymmetry head noticeably increased (Fig. 1).
Treatment. With the discovery of deformation should begin conservative treatment: corrective gymnastics (the inclination of the head to the opposite side and turn towards the shortened muscles), ov-stroking the affected muscle, warm neck blue light, by the "Hairdryer", heaters. To put the child to bed, so that the position of the head corrected. The ineffectiveness - operation (children aged 4 years).
Klippel - Fala disease - fusion cervical and vermehrung vertebrae. Formed bone mass, which height is less than the normal length of the spine. Neck in these patients is very short, it seems that it is missing. Treatment, therapeutic exercises.
Pterygoid neck is one of the rare congenital deformations of the neck (see Shereshevsky - Turner syndrome), which received its name due to the presence of two skin folds, strained in the form of triangular sails of the lateral surfaces of the head to the shoulder girdle. More often folds are only duplikatory skin. Treatment - plastic surgery.
The acquired form Krivoshei. Grizela disease - torticollis due to the inclined position Atlanta (I cervical vertebra). Under the influence of inflammation in the throat or mouth firmly shortened predposlednie muscles, which leads to subluxation Atlanta. The disease occurs in children 6 to 10 years. Usually unexpectedly there is a persistent downward position of the head. Treatment: antibiotics, anti-inflammatories, traction with a loop Glisson.
Germinoguenne torticollis occurs after extensive damage to the skin of the neck due to wounds, disease, syphilitic ulcers, especially burns III and IV degree for secondary healing.
Torticollis may be the result of a fracture or dislocation of the cervical vertebrae.
Spine diseases (tuberculosis, osteomyelitis, a actinomycosis, malignant neoplasms) sometimes lead to pathological fractures of the vertebral bodies and the emergence Krivoshei.
Spastic torticollis is one of the types of hyperkinesis (see). Is characterized by involuntary movements or forced position of the head in the striped, typically tonic clonic and, spasms of the neck muscles (Fig., 2). Frequent reason spastic Krivoshei are encephalitides. Treatment during the initial period of the disease protivoepilepticheskie therapy, and with a sudden spastic forms Krivoshei - neurosurgical operations.
Reflex and compensatory Krivoshei. Reflex torticollis is observed in inflammatory processes of the middle ear, the mastoid process, when perichondritis ribs and inflammatory processes in the neck. The patient, to reduce pain, aggravated by stretching the muscles, tilts his head. Compensatory Krivoshei observed in some diseases of the inner ear (labyrinthitis) and eye (cataracts, strabismus, and others). Patients bow the head, giving it a position in which no dizziness and best use of the field of view.