# Bilateral congenital muscular torticollis in infants, report of two cases

## TL;DR

This paper reports two rare cases of bilateral congenital muscular torticollis in infants and describes their symptoms and treatment outcomes.

## Contribution

The paper provides a detailed description of bilateral CMT in infants, a rare and less understood condition.

## Key findings

- Both infants showed improved range of motion and head posture after treatment.
- One infant still requires additional training for full recovery.
- Long-term follow-up is recommended to better understand bilateral CMT.

## Abstract

Congenital muscular torticollis (CMT) is a well-known diagnosis among physiotherapists specializing in pediatric care, especially when working with infants. However, knowledge of bilateral torticollis is limited. The purpose of this article was to describe how bilateral torticollis can appear in infants.

One infant with CMT with sternocleidomastoid tumor (SMT) on the right side, and some limitation in rotation towards the right side and in lateral flexion towards the left side, that is, the muscle on the right side was shortened. While sitting with support, he tilted the head to the left and was stronger in the lateral flexors on the left side which fit well with a postural left-sided torticollis (PT). The other infant had bilateral muscular torticollis (MT), the sternocleidomastoid muscle thickened bilaterally, and both active and passive rotations were affected. The head was held in flexion, and active rotation was severely limited to both sides. For both cases the therapeutic interventions were to gain a normal range of motion (ROM) and a good posture of the head.

CMT can appear in different ways and may be bilateral. Both infants gained good ROM and better head position, however case I still needs some training. To gain more knowledge about bilateral CMT, we should follow these cases over a longer period of time. It is important to communicate and discuss our experiences with each other to understand rare cases of CMT.