Hobaek Siegenthaler Mette
Chiropractor, Holbeinpraxis, Swiss Academy for Chiropractic, Berne, Switzerland.
J Chiropr Med. 2015 Mar;14(1):51-6. doi: 10.1016/j.jcm.2014.12.003. Epub 2015 Feb 20.
The purpose of this case report is to describe the chiropractic management of a child with abnormal fixation of one eye and torticollis.
A mother presented with a concern regarding her 23-month-old son who had a history of torticollis and an abnormal fixation of the right eye. She noticed the head tilt when he was about 7 months old and abnormal alignment of the right eye when the boy was 18 months old. At 15 months when he took his first steps, his head tilt became worse. At 21 months old, a neurological and orthopedic examination at the regional university children`s hospital ruled out presence of a tumor of the cervical spine or posterior fossa. The orthopedist sent the baby for chiropractic evaluation and treatment. Chiropractic exam found decreased active and passive range of motion in the cervical spine and no evidence of mass or contracture of the sternocleidomastoid muscle. Segmental palpation showed a decreased joint play and pain reaction at level C1/C2 on the right.
The chiropractic treatment consisted of spinal manipulative therapy of the cervical spine in addition to massage and stretching of the neck muscles. Within a period of 4 weeks (3 chiropractic treatments) the torticollis was nearly resolved and the abnormal fixation of the right eye was no longer apparent. No relapse of the symptomatology was observed at a follow-up consultation at 26 months.
The patient responded favorably to chiropractic care, showing a possible mechanical spinal cause for his torticollis and for the secondarily developed abnormal fixation of the right eye.
本病例报告旨在描述对一名患有单眼异常注视和斜颈的儿童进行的整脊治疗。
一位母亲对她23个月大的儿子表示担忧,该男孩有斜颈病史和右眼异常注视。她在孩子大约7个月大时注意到头部倾斜,在18个月大时发现右眼有异常斜视。15个月大开始走路时,他的头部倾斜变得更严重。21个月大时,在地区大学儿童医院进行的神经科和骨科检查排除了颈椎或后颅窝肿瘤的存在。骨科医生将婴儿送去接受整脊评估和治疗。整脊检查发现颈椎的主动和被动活动范围减小,胸锁乳突肌无肿块或挛缩迹象。节段触诊显示右侧C1/C2水平的关节活动度减小和疼痛反应。
整脊治疗包括颈椎的脊椎手法治疗以及颈部肌肉的按摩和拉伸。在4周内(3次整脊治疗),斜颈几乎得到解决,右眼的异常注视也不再明显。在26个月的随访咨询中未观察到症状复发。
患者对整脊治疗反应良好,表明其斜颈以及继发出现的右眼异常注视可能存在脊柱机械性病因。