Myogenic Torticollis

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MAIN POINTS FOR DIAGNOSIS

 
The head is deviated to the affected side and bends forward, while the face turns to the healthy side.Or even the asymmetric sides of the face develops, that is, the healthy side is relatively large while the affected side small.
 
After the affected baby is born, a fusiform mass on one side of his or her neck can be observed, (some may disappear voluntarily in half a year), later gradual contracture of the muscles on the affected side takes place, and finally protrudes like a cord.

If treatment is not given to the problem for a long time, the cervical vertebrae may protrude to the healthy side, and compensatory lateral curvature of the thoracic vertebrae and ambiopia may even develop.

Myogenic torticollis is a disease marked with the headdeviated to one side. It is often seen in infants. In  modernmedicine, myogenic torticollis is mainly because of malpo-sition of the fetus in the uterus, which causes pressure a-gainst the sternocleidomastoid muscle on one side and ob-struction of blood circulation leading to ischemic fibrosis ofthe muscle. And it may also be due to malposition of the fetus during delivery, which causes the sternocleidomas-toid muscle to be pressed by the birth canal or by obstetric forceps so as to be injured and bleed with formation of he-matoma. It further develops into contracture due to or-ganization of the hematoma, which results in the occur-mechanism of the deviated head lies in disorders of qi andblood, obstruction of the meridians, and stagnation of qi as well blood stasis.
    
BASIC MANIPULATIONS
 
The principle of tuina therapy: relaxing muscles andtendons, promoting circulation of blood, softening and re-solving hard mass.
 

 
Gently lift and grasp the sternocleidomastoid muscle on the affected side for 1 - 3 minutes, then wipe and pluck the tendons on the affected side along their di-rections with the thumb and the index finger 10 - 15times.

Have the infant lie on his back at the edge of thebed, and his head direct at the doctor, and the doctor sits at a chair in front of the bed. Hold the neck of the patientwith one hand, and press-knead the affected side of his neck with the thumb, or the index, the middle and thering fingers for 5 - 10 minutes, combined with finger-twisting to disperse the swelling lump gently. Apply more manipulations to the beginning and the ending parts of the sternocleidomastoid muscle on the affected side. 
 
Pull or rotate the patient's head toward the healthy side repeatedly several times. The manipulation should be performed first lightly, then gradually heavily with an increasing amplitude; sudden, violent exertion of force beyond the physiological limitation should be avoided.
 
Finally perform pressing-kneading manipulation to relax the affected area for 3 - 5 minutes.
   
MODIFIED MANIPULATIONS WITH SYNDROME DIFFERENTIATION
    
If the patient has been troubled by myogenic torticollis for quite a long time, the two sides of the face have been different in size, and the affected side of the neck has been hard, the following manipulations may be added to the basic ones.
   
Digitally-knead Taiyang (EX-HN 5 ), Yintang (EX-HN 3) and Dicang (ST 4) on the affected side of the face for one minute respectively.
   
Digitally-press Hegu (LI 4) and Waiguan (TE 5) for one minute respectively.
   
Pluck Yinlingquan (SP 9) and Juegu (GB 39) 10 times respectively. The treatment of myogenic torticollis is usually given once a day, 10 - 15 minutes each time. One treatment course takes a month, and the number of courses is in direct proportion to the hardness of the muscles on the affected side. The manipulation should couple hardness with gentleness, and violent operation mustn't be done. What's more, the media talcum is used to protect children's skin.While the infant is in sleep, intentionally have his head turn to the healthy side to correct the malformation

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