From the Guidelines
For acute torticollis in a 10-year-old, treatment is not usually needed unless symptoms of irritability, discomfort, or vomiting necessitate symptomatic management. According to the expert consensus in China, as reported in the study published in Translational Neurodegeneration in 2021 1, benign paroxysmal torticollis (BPT) is characterized by recurrent episodes of abnormal, painless head postures, and treatment is often not required. However, if symptoms do necessitate management, gentle measures such as heat application and over-the-counter pain medications like ibuprofen or acetaminophen may be considered to reduce discomfort. Some key considerations for managing acute torticollis in a 10-year-old include:
- Gentle heat application to relieve muscle tension
- Over-the-counter pain medications like ibuprofen (10 mg/kg every 6-8 hours, not exceeding 600 mg per dose) or acetaminophen (15 mg/kg every 4-6 hours, not exceeding 1000 mg per dose) for symptomatic relief
- Gentle stretching exercises to maintain range of motion, having the child slowly turn their head toward the affected side and hold for 10-15 seconds, repeating 5-10 times per session
- Ensuring proper sleeping positions with appropriate pillow support and taking regular breaks from activities requiring prolonged neck positioning It is essential to monitor the child's symptoms and seek prompt medical evaluation if they worsen, persist beyond 2 weeks, or are accompanied by fever, severe headache, or neurological symptoms to rule out more serious underlying conditions, as suggested by the study 1.
From the Research
Treatment Options for Acute Torticollis in a 10-year-old
- The treatment for acute torticollis in a 10-year-old can vary depending on the underlying cause of the condition.
- In cases where the torticollis is caused by a deep neck infection, the use of point-of-care ultrasound (POCUS) can help diagnose and guide the treatment 2.
- For cases of torticollis caused by muscle spasms or musculoskeletal conditions, skeletal muscle relaxants such as cyclobenzaprine, carisoprodol, orphenadrine, and tizanidine may be effective in relieving symptoms 3.
- However, it is essential to note that cyclobenzaprine can rarely cause extrapyramidal symptoms, including torticollis, especially in cases of liver impairment 4.
Classification and Diagnosis of Torticollis
- Torticollis can be classified into nonparoxysmal (nondynamic) or paroxysmal (dynamic) types, depending on its dynamic qualities and pathogenesis 5.
- The diagnosis of torticollis involves a thorough evaluation of the patient's medical history, physical examination, and laboratory tests to determine the underlying cause of the condition.
- In some cases, imaging studies such as X-rays or CT scans may be necessary to rule out other conditions that may be causing the torticollis.
Importance of Early Diagnosis and Treatment
- Early diagnosis and treatment of acute torticollis are crucial to prevent long-term complications and improve treatment outcomes 2.
- In cases where the torticollis is caused by a deep neck infection, prompt antibiotic treatment and drainage of the infection can help prevent serious complications 2.
- For cases of torticollis caused by muscle spasms or musculoskeletal conditions, early treatment with skeletal muscle relaxants and physical therapy can help relieve symptoms and improve range of motion.