Transient Motor Asymmetry Among Infants With Congenital Torticollis-Description, Characterization, and Results of Follow-Up

AIM: The purpose of this study was to assess the prevalence of transient functional motor asymmetry in infants with congenital postural torticollis. METHODS: This was a retrospective review of the medical records of infants with postural torticollis. We analyzed epidemiological, obstetric, perinatal data, physical therapy, physician assessments, and clinical follow-up for two years after diagnosis. RESULTS: Of 173 children, 44 (25.4%, 95% confidence interval = 19.5 to 32.4) demonstrated functional asymmetry. Demographic and obstetrical data did not differ between the asymmetry/nonasymmetry groups. Delayed motor development (P = 0.01) and plagiocephaly (P = 0.032) were more common in infants with motor asymmetry. No difference was observed in the frequency of referral for further neurological diagnosis between the group with functional asymmetry and that without asymmetry. Among the 44 patients with functional asymmetry, 78% depicted no evidence of torticollis by age two years, and the motor asymmetry had disappeared in 82%. CONCLUSION: Benign, transient functional motor asymmetry occurred in a quarter of infants with congenital postural torticollis. Transient motor delay was also significantly more common in the asymmetry group. In most instances, motor asymmetry and motor delay disappeared by age two years. Plagiocephaly was more common in the asymmetry group. Clinician awareness of this transient asymmetry may have avoided unnecessary diagnostic tests in these infants.