嬰兒姿勢性斜頸症之兩年計劃性研究

A Two-Year Prospective Study of Infant Postural Torticollis

楊百嘉(Baii-Jia Yang) ； 林蕙秋(Hwei-Chu Lin)

《中華民國復健醫學會雜誌》 27卷1期 (1999/03) Pp. 1-6

https://doi.org/10.6315/JRMA.199903.0001

摘要

211例嬰兒斜頸症中130例（I 組）為頭部傾斜臉部不對稱，但無肌肉病變及頸部旋轉限制之姿勢性斜頸症者，佔總數61.6% ；其餘81例（II 組）為同時有肌肉病變及頸部不同程度之旋轉限制的肌肉性斜頸症者，佔總數38.4%。I組在三個月內來看初診者佔32.3%，而II 組在三個月內來看初診者佔77%。以家族史來看有7例（3.3%）為家族史中同時出現兩位斜頸症者。I 組可追蹤者為95例，其中有37例為頭部傾斜角度大或等於15°，皆接受肌肉電刺激、頸圈及運動治療，平均治療期為3.3±2.4個月，恢復情況－無頸部傾斜及小於等於5°者佔73％，大於5°者佔27%，另58例為頭部傾斜度較輕微者，給予家中運動指導或頸圈治療後皆大有進步。嬰兒姿勢性斜頸症之報告很少，但其型態與治療方式皆與肌肉性斜頸症不同，可供大家參考。

關鍵字

姿勢性斜頸症 ； 肌肉性斜頸症 ； 肌肉電刺激 ； 頸圈

並列摘要

Torticollis is a common physical finding in infants, and congenital muscular torticollis is the most commonly reported type. If the only findings are head tilting and facial asymmetry without limitation of ROM of the neck and lack of pathological change of the sternocleidomastoid muscle, infant postural torticollis is the most likely diagnosis. From June, 1995 to May, 1997 we prospectively studied 211 cases of postural and muscular torticollis and excluded other causes of head tilting. The male to female ratio was 114:97, and left to right side ratio 104:107. 130 cases (61.6%) had infant postural torticollis (Group I), while 81 had congenital muscular torticollis (Group II). Seven patients (3.3%) had sibling or cousins with postural or muscular torticollis.
In Group I, 95/130 cases could be followed up. Of these 95 patients 37 patients with angle of head tilting≧15°, electrical muscular stimulation on the opposite side trapezius muscle, neck collar support over tilting side, passive stretch, righting reflex and active exercise program were given. This approach resulted in total correction in 7, slight tilting (≦5°) in 20, and less improvement with tilting (＞5°) in 10 cases. The treatment period of this group was 3.3 ± 2.4 months. In the other 58 cases, with initial head tilting less than 15°, most of them were treated with exercise program and collar. All resulted in marked improvement. The facial asymmetry also showed marked improvement at the same time. In Group II, all received conservative physiotherapy with marked improvement, but 10 cases (12%) had poor results and went on to surgical treatment.

並列關鍵字

postural torticollis ； muscular torticollis ； electrical muscular stimulation ； neck collar