Congenital torticollis involves abnormal  function of the
sternocleidomastoid(SCM) muscle.[The big muscle on each side that goes from
the stenum (breastbone) to behind the ear]  It can appear in the second to
fourth week of life, with fibrotic shortening of the SCM causing the head to
be tilted  so the chin points away from  the affected side and the neck is
flexed toward the lesion.   The  "mass" or "bump" felt at the   midportion
of the  SCM is actually fibrous transformation.

Torticollis can also be related to upper respiratory infection, trauma,
spinal cord or cerebellar tumors,  syringomyelia (another spinal cord
problem) or rheumatoid arthritis.  In these cases [with  the possible
exception of trauma] you would NOT expect to feel a bump in the muscle.

I've seen (or shall I say felt) both kinds.    I've also seen one case of
head tilting being an eye problem as  well.

Hope this makes things more clear.

Gail Hertz, MD, IBCLC

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