Pediatric Rehabilitation Lecture Series: Torticollis and Plagiocephaly Care-Session Recording

Video Transcription

Video Summary

The recorded lecture presented by Dr. Amy Canalican focuses on the diagnosis and management of torticollis and related conditions in pediatric patients. Dr. Canalican is an assistant professor at the University of Colorado and a pediatric physiatrist. She outlines the anatomy and causes of torticollis, highlighting congenital muscular torticollis, which often involves the sternocleidomastoid muscle, and discusses potential factors such as in utero positioning. The lecture emphasizes the importance of early intervention and skilled physical therapy to manage torticollis effectively. Dr. Canalican explains that, ideally, physical therapy should begin as early as possible to enhance the prognosis and reduce treatment duration. She also mentions other etiologies, like ocular causes and congenital anomalies, which may require consideration in a differential diagnosis.<br /><br />In terms of treatment, emphasis is given to physical therapy and caregiver education, with key elements being cervical strengthening, symmetric gross motor skills development, and environmental changes. In cases where progress is inadequate, Dr. Canalican discusses the potential administration of botulinum toxin injections as an off-label intervention and suggests surgical options as a last resort.<br /><br />Additionally, the lecture addresses abnormal head shapes, such as plagiocephaly, and the use of cranial orthoses (helmets) to correct severe deformities. Severity scales, measurements, and 3D scans are used to guide treatment options. The importance of distinguishing between positional plagiocephaly and craniosynostosis is underscored, with the latter requiring different management due to the premature fusion of skull sutures.<br /><br />Dr. Canalican also highlights the necessity of a multidisciplinary approach, incorporating consultations with neurology, ophthalmology, and craniofacial specialists as appropriate, to provide comprehensive care for these pediatric conditions.

Keywords

torticollis

pediatric physiatry

congenital muscular torticollis

early intervention

physical therapy

botulinum toxin injections

plagiocephaly

cranial orthoses

multidisciplinary approach

differential diagnosis