Nucci Paolo, Kushner Burton J, Serafino Massimiliano, Orzalesi Nicola
Pediatric Ophthalmology & Strabismus Unit San Paolo Hospital University of Milan, Italy.
Am J Ophthalmol. 2005 Jul;140(1):65-8. doi: 10.1016/j.ajo.2005.01.037.
To determine the relative frequency that abnormal head postures in children are caused by orthopedic, ophthalmologic, or neurologic disorders, respectively.
A prospective, consecutive case series.
Children found to have an abnormal head posture on routine pediatric examination underwent an evaluation by a pediatric ophthalmologist, pediatric orthopedist, and pediatric neurologist. The study was conducted in northwestern Italy.
In the 63 children evaluated, the cause of the abnormal head posture was orthopedic in 35, ocular in 25, and neurologic in 5. In 8 patients, no specific cause could be found. The most common orthopedic cause was congenital muscular torticollis, which accounted for 31 patients. The most common ocular cause was superior oblique muscle palsy, which accounted for 12 patients. In 2 patients neck muscle contracture suggested an orthopedic cause, however, the tight neck muscles were secondary to a head tilt caused by superior oblique muscle palsy.
When the cause of an abnormal head posture is not obvious, a multi-disciplinary approach including ophthalmologic, neurologic, and orthopedic specialists may be helpful.
确定儿童异常头位分别由骨科、眼科或神经科疾病引起的相对频率。
一项前瞻性连续病例系列研究。
在常规儿科检查中发现有异常头位的儿童接受了儿科眼科医生、儿科骨科医生和儿科神经科医生的评估。该研究在意大利西北部进行。
在评估的63名儿童中，异常头位的原因是骨科疾病的有35例，眼科疾病的有25例，神经科疾病的有5例。8例患者未发现具体病因。最常见的骨科病因是先天性肌性斜颈，占31例。最常见的眼科病因是上斜肌麻痹，占12例。2例患者颈部肌肉挛缩提示骨科病因，然而，紧张的颈部肌肉是由上斜肌麻痹导致的头部倾斜继发而来。
当异常头位的病因不明显时，包括眼科、神经科和骨科专家在内的多学科方法可能会有所帮助。
