Differential Diagnosis for Head Drop in a 6-Month-Old
Single Most Likely Diagnosis
- Benign Congenital Muscular Torticollis or Physiological Head Lag: This condition is common in infants and can cause the head to drop due to muscle weakness or imbalance. It's often seen in infants who prefer to sleep with their heads turned to one side, leading to a shortening of the sternocleidomastoid muscle.
Other Likely Diagnoses
- Hypotonia: Generalized low muscle tone can cause a head drop in infants, as the muscles in the neck are not strong enough to support the head.
- Developmental Delay: Infants with developmental delays may exhibit head lag or drop due to overall muscle weakness or neurological immaturity.
- Cervical Spine or Musculoskeletal Issues: Conditions affecting the cervical spine or musculoskeletal system, such as Klippel-Feil syndrome, can lead to head drop.
Do Not Miss Diagnoses
- Spinal Muscular Atrophy (SMA): A genetic disorder that affects nerve cells responsible for controlling voluntary muscle movement, leading to muscle weakness and wasting. Early diagnosis is crucial for treatment.
- Metabolic Disorders: Certain metabolic disorders, such as Pompe disease or other glycogen storage diseases, can cause muscle weakness leading to head drop.
- Infections or Inflammatory Conditions: Meningitis, encephalitis, or other infections/inflammatory conditions affecting the central nervous system can cause muscle weakness, including head drop.
Rare Diagnoses
- Prader-Willi Syndrome: A rare genetic disorder that can cause hypotonia, among other symptoms, leading to head drop.
- Myasthenia Gravis: A rare autoimmune disorder that can cause muscle weakness, including in the neck muscles, leading to head drop.
- Congenital Myopathies: A group of rare muscle disorders present at birth that can cause muscle weakness, including head drop.