Congenital muscular torticollis and positional plagiocephaly

Pediatr Rev. 2014 Feb;35(2):79-87; quiz 87. doi: 10.1542/pir.35-2-79.


On the basis of observational studies, child health practitioners in primary care settings should consider the diagnosis of congenital muscular torticollis (CMT)in infants with risk factors from birth history for intrauterine malpositioning or constraint (C). On the basis of observational studies, CMT is often associated with other conditions, including positional plagiocephaly and gross motor delays from weakened truncal muscles and/or lack of head control in early infancy (C). On the basis of observational studies, child health practitioners should counsel parents that infants should be on their stomachs frequently whenever they are awake and under direct adult supervision to develop their prone motor skills (C). On the basis of consensus, early identification of CMT(with or without positional plagiocephaly) and prompt referral to a physical therapist experienced in the treatment of CMT should be considered to avoid more costly or invasive treatments, such as cranial orthoses or surgery (D).

Publication types

  • Review

MeSH terms

  • Botulinum Toxins / therapeutic use
  • Diagnosis, Differential
  • Humans
  • Infant
  • Muscle, Skeletal / surgery
  • Orthotic Devices
  • Physical Therapy Modalities
  • Plagiocephaly, Nonsynostotic* / complications
  • Plagiocephaly, Nonsynostotic* / epidemiology
  • Plagiocephaly, Nonsynostotic* / physiopathology
  • Plagiocephaly, Nonsynostotic* / prevention & control
  • Posture
  • Primary Health Care
  • Skull
  • Torticollis / complications
  • Torticollis / congenital*
  • Torticollis / epidemiology
  • Torticollis / physiopathology
  • Torticollis / therapy


  • Botulinum Toxins

Supplementary concepts

  • Congenital torticollis