Turkish Neurosurgery 2021 , Vol 31 , Num 3
The Spectrum of Underlying Diseases in Children with Torticollis
Abdulfettah TUMTURK1,Sureyya Burcu GORKEM2,Elif Nurdan OZMANSUR3, Yakup PEDUK4,Umit ARSLAN3,Veysel GOK5,Hakkı DOGAN6,Benhur Sirvan CETIN7,Ali SAHIN8,Hakan GUMUS4,Ahmet GUNEY9,Ekrem UNAL5,Ali KURTSOY1,Huseyin PER4,/
1Erciyes University, Faculty of Medicine, Department of Neurosurgery, Kayseri, Turkey
2Erciyes University, Faculty of Medicine, Department of Radiology, Division of Pediatric Radiology, Kayseri, Turkey
3Erciyes University, Faculty of Medicine, Department of Pediatrics, Kayseri, Turkey
4Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Kayseri, Turkey
5Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology & Pediatric HSCT Unit, Kayseri, Turkey
6Maya Goz Hospital, Department of Ophthalmology, Kayseri, Turkey
7Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Infection Disease, Kayseri, Turkey
8Kayseri City Education and Research Hospital, Department of Neurosurgery, Kayseri, Turkey
9Erciyes University, Faculty of Medicine, Department of Orthopedics, Kayseri, Turkey
DOI : 10.5137/1019-5149.JTN.31359-20.2 AIM: To investigate the underlying conditions in children with torticollis.

MATERIAL and METHODS: Between May 2016 and December 2019, 24 patients (10 girls and 14 boys; mean age, 8 years) presenting with twisted neck, neck pain, weakness of extremities, imbalance, and gait disorder were evaluated retrospectively.

RESULTS: Five of the patients had cranial pathologies (cerebellar anaplastic ependymoma and medulloblastoma, brain stem glioma, atypical teratoid rhabdoid tumor, and acute disseminated encephalomyelitis), and five of the patients had spinal pathologies (idiopathic intervertebral disc calcification, vertebral hemangiomatosis, compression fracture, multiple hereditary exostoses, and Langerhans cell histiocytosis at C4). Six of the patients had ocular pathologies (strabismus, Duane syndrome, and Brown syndrome each in two patients). Four patients had otorhinolaryngological infections (Sandifer syndrome, esophageal atresia, reflux, and spasmus nutans, with one patient each). Detailed clinical physical examination and necessary laboratory investigation were performed for all patients.

CONCLUSION: Torticollis is a sign that is not always innocent and may herald an underlying severe disease. Misdiagnosis can lead to wrong and unnecessary surgical procedures and treatments, and sometimes, the results can be damaging due to underlying severe conditions if diagnosed late. In addition, we first report a case of vertebral hemangiomatosis and temporomandibular joint ankylosis that presented with torticollis in the English medical literature. Keywords : Etiology, Physical examination, Radiology, Torticollis

Corresponding author : Huseyin PER, huseyinper@yahoo.com, hper@erciyes.edu.tr