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

Background: 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 may present itself clinically.

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

Conclusions: 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.