Fifteen-minute consultation: Evaluation of paediatric torticollis

2021 ◽  
pp. edpract-2020-319668
Author(s):  
Kavinda Dayasiri ◽  
Sahana Rao
Keyword(s):  
Clinical Approach ◽  
Careful Evaluation ◽  
Presentation Duration ◽  
Congenital Muscular Torticollis ◽  
Live Births ◽  
Presenting Symptoms ◽  
Life Threatening ◽  
Muscular Torticollis

Torticollis refers to a state in which the neck is twisted due to excessive contraction or shortening of the muscles on one side. Congenital muscular torticollis, which is more common than acquired torticollis, has an incidence of 0.3%–1.9% among all live births. The clinical approach to torticollis depends on the age at presentation, duration of torticollis and presenting symptoms. The underlying aetiology for torticollis varies with the age of the child. Torticollis can be a presenting feature for life-threatening conditions and thus requires careful evaluation.

scholarly journals Algorithm for torticollis diagnosis in children of younger age groups

2021 ◽  
Vol 9 (4) ◽  
pp. 477-490
Author(s):  
Yuriy E. Garkavenko ◽  
Alexander P. Pozdeev ◽  
Irina A. Kriukova
Keyword(s):  
Differential Diagnosis ◽  
Age Groups ◽  
Careful Examination ◽  
Older Children ◽  
Congenital Muscular Torticollis ◽  
Younger Age ◽  
Keywords And Phrases ◽  
Abnormal Head ◽  
Life Threatening ◽  
Muscular Torticollis

BACKGROUND: Torticollis is a common term for abnormal head or neck positions. Torticollis can be due to a wide variety of pathological processes, from relatively benign to life-threatening. This syndrome is of particular relevance in pediatric practice and is often underestimated at the primary care level. AIM: To analyze the data of domestic and foreign literature on the etiopathogenesis and clinical features of various types of torticollis in children and develop algorithms for the differential diagnosis of torticollis in children of younger age groups. MATERIALS AND METHODS: A literature search was conducted in the open information databases of eLIBRARY and Pubmed using the keywords and phrases: torticollis, congenital muscular torticollis, non-muscular torticollis, acquired torticollis, and neurogenic torticollis, without limiting the depth of retrospection. RESULTS: Based on the literature data generalization, the classification of torticollis and the key directions of its differential diagnosis are systematized in tabular form. The range of differential diagnosis of torticollis is quite wide and has its characteristics in newborns and children of the first years of life, contrary to older children. The most common is congenital muscular torticollis. Concurrently, non-muscular forms of torticollis in the aggregate are not uncommon, more often with a more serious etiology, and require careful examination. Based on the analyzed literature, differential algorithms for torticollis diagnosis in children of younger age groups have been compiled. CONCLUSIONS: Increasing the level of the knowledge of pediatric clinicians in the etiopathogenesis of torticollis syndrome will improve the efficiency of early diagnosis of dangerous diseases that lead to pathological head and neck positions in children.

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

Evaluation of the Clinical Role of Strain Elastography in Patients Diagnosed With Congenital Torticollis

2021 ◽  
pp. 875647932098324
Author(s):  
Elif Özyazici Özkan ◽  
Mehmet Burak Ozkan ◽  
İshak Abdurrahman İsik
Keyword(s):  
Area Under The Curve ◽  
Muscle Group ◽  
Receiver Operating Curve ◽  
Control Group ◽  
Clinical Role ◽  
Congenital Muscular Torticollis ◽  
Cutoff Value ◽  
Strain Elastography ◽  
Specificity And Sensitivity ◽  
Muscular Torticollis

Objective: The objective of this study was to determine the elasticity of sternocleidomastoid muscle (SCM) in patients with congenital muscular torticollis (CMT). Methods: In all, 41 patients and 22 controls were included in the study, and the elasticity of the patients’ SCM was measured. Echogenicity, thickness, and strain values of the SCM were also obtained. Results: The thickness and strain values of the SCM were higher in the patient group than in the control group ( P = .02 and P = .15). For median values, there was no difference in echogenicity and strain. In the strain elastography evaluation of the receiver operating curve (ROC) for muscle echogenicity in the isoechoic muscle group, the specificity and sensitivity were determined to be 100% and 22%, respectively, for the area under the curve (AOC) value of 0.558 (95% confidence interval [CI], 0.424–0.6686), and the cutoff value was <1.4. In the hyperechoic muscle group, the ROC for AUC values was found to be 0.542 (95% CI, 0.411–0.6686), and the cutoff value was >1.4 with 100% sensitivity and 20.75 specificity. Conclusions: The strain elastography technique can be used in the diagnosis of CMT.

Cervical Spine Subluxation Associated with Congenital Muscular Torticollis and Craniofacial Asymmetry

1993 ◽  
Vol 91 (7) ◽  
pp. 1196-1197
Author(s):  
R. Kendrick Slate ◽  
Jeffrey C. Posnick ◽  
Derek C. Armstrong ◽  
J. Raymond Buncic ◽  
Milton T. Edgerton
Keyword(s):  
Cervical Spine ◽  
Congenital Muscular Torticollis ◽  
Muscular Torticollis

Familial Congenital Muscular Torticollis

1986 ◽  
Vol &NA; (202) ◽  
pp. 193???196 ◽  
Author(s):  
F. THOMPSON ◽  
S. MCMANUS ◽  
J. COLVILLE
Keyword(s):  
Congenital Muscular Torticollis ◽  
Muscular Torticollis

Application of Ultrasonography During Sternocleidomastoid Muscle Release for Congenital Muscular Torticollis

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Hyonmin Choe ◽  
Naomi Kobayashi ◽  
Masatoshi Oba ◽  
Akira Morita ◽  
Koki Abe ◽  
...  
Keyword(s):  
Sternocleidomastoid Muscle ◽  
Congenital Muscular Torticollis ◽  
Muscular Torticollis

Bradyarrhythmias

2016 ◽  
Author(s):  
Inna Leybell ◽  
Liliya Abrukin
Keyword(s):  
Atrioventricular Block ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Treatment Options ◽  
Presenting Symptoms ◽  
Threatening Condition ◽  
Node Disease ◽  
Life Threatening ◽  
Sinus Node Disease ◽  
Sinoatrial Block

Bradyarrhythmias can present as an incidental electrocardiographic (ECG) finding or a life-threatening condition requiring immediate intervention. They are caused by sinus node disease or atrioventricular block. This review covers pathophysiology, stabilization and assessment, diagnosis and treatment options, and disposition and outcomes for patients with bradycardia. Figures in the review demonstrate characteristic ECG tracings. Tables list classifications of sinus node dysfunction as well as of sinoatrial and atrioventricular blocks, presenting symptoms, important information to elicit on history taking, various causes of bradycardia, and specific interventions for toxicologic etiologies. Key words: atrioventricular block, atropine, bradyarrhythmia, bradycardia, first-degree atrioventricular block, second-degree atrioventricular block, sinoatrial block, sinus bradycardia, sinus node disease, tachycardia-bradycardia syndrome, third-degree atrioventricular block This review contains 9 highly rendered figures, 7 tables, and 92 references.

URIC ACID LEVEL AS A PREDICTOR OF SEVERITY IN PREGNANT WOMEN WITH SEVERE PREECLAMPSIA

2021 ◽  
pp. 327-331
Author(s):  
Natasya Natasya ◽  
Fidel Ganis Siregar ◽  
Ratna Akbari Ganie
Keyword(s):  
Developing Countries ◽  
Uric Acid ◽  
Pregnant Women ◽  
Acid Level ◽  
Developed Countries ◽  
Multiple Organ ◽  
Live Births ◽  
Obstetric Emergency ◽  
Organ Systems ◽  
Life Threatening

Preeclampsia is a pregnancy syndrome affecting multiple organ systems, characterized by hypertension and proteinuria after 20 weeks of gestation. The incidence of preeclampsia is estimated to be 3-10% of pregnancies worldwide and is the leading cause of death for pregnant women. Preeclampsia is a life-threatening obstetric emergency, so it needs prompt and precise treatment to prevent morbidity and mortality. WHO estimates that the incidence of preeclampsia is seven times higher in developing countries (2.8% of live births) than in developed countries 1,2 (0.4%).

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