A Sytematic Review on the Definition, Nomenclature and Classification on Infantile Asymmetry, respectively, Torticolllis in Infants



The goal of this review is to describe the different causes, nomenclatures and definitions for postural and movement restrictions in the area of the atlanto-occipital joint and cervical spine of infants. The terms “torticollis” and “infantile asymmetry” will also be elaborated upon. A further aspect will discuss the clinical picture of “Kiss syndrome”. By means of literature research, diagnostics and therapy will be addressed.

The selection of studies is achieved by using electronic data bases like Medline, Proquest, and Cinahl. Keywords in the literature research are “ torticollis”, “infant”, “wry neck”, “asymmetrie”, “classification”,”nomenclature”,”term”,”diagnosis”, and “therapy”. The results undergo a selection according to relevant criteria. Established textbooks are also used for research.

From a total of 3762 published articles relating to the subject, 49 were used for the thesis, regardless of the study design. Today the term “torticollis” is widely used in medicical literature . The same is true for the country – specific translations: “Schiefhals”in the German and“wry neck” in the English language. . Some authors limit the word torticollis to describe only a muscular cause, others use it to describe a clinical picture. Approximately 80 different causes for the development of a torticollis are established which are divided in congenital and acquired etiologies. The cause for a congenital muscular torticollis (CMT) is controversely disputed in literature. Both a detailed case history followed by a physical examination are required to place a diagnosis. In order to determine the range of motion, a particular type of protractor (arthrodial protractor) is used. Particularly in clinical studies, video assisted mobility ratings can be applied. Stretching programs as well as physiotherapeutical measures are common ways to treat CMT. There is evidence from a few randomized and controlled studies that indicates the effectiveness of osteopathy.

The clinical picture of torticollis in medical literature is heterogenous in terms of the used nomenclatures, definitions, classifications, etiologies, diagnostics, and therapies. . Precisely formulated criteria of inclusions and exclusions, as well as the use of validated measuring methods, are of great importance for clinical studies within osteopathic research.