Objective: Torticollis is a clinical sign characterized by rotational deformity of the cervical spine with secondary tilting of the head. Besides congenital causes, many underlying conditions may give rise to torticollis. The aims of the study are to assess the congenital and acquired distributions of patients diagnosed with torticollis and to identify the underlying causes of the event and to evaluate the associated symptoms to determine clinical severity especially in patients with acquired torticollis.

Material and Methods: The records of the paediatric patients who were admitted to the general paediatric outpatient clinics of our hospital and diagnosed with torticollis between January 2011 and November 2018 were evaluated. Demographic  data,  presentation  symptoms,  physical  examination  findings,  laboratory  and  radiological  data  of  the patients were recorded.

Results: Among a total of 532 patients presented with torticollis, 44.3% (n = 232) of them were of acquired torticollis group. The most common causes of acquired torticollis were infections (29.3%) and postural torticollis (13.2%). In nine patients, torticollis was developed due to rare causes. These rare causes were Grisel’s syndrome (n = 5), strabismus (n = 2), Sandifer’s syndrome (due to citrullinemia) (n = 1) and leukaemia (n = 1) respectively. Vomiting (OR:23.1[13.6-42.1]), fever (OR:5.1 [2.6-7.8]) and dysphagia (OR: 19.6 [7.2-32.5]) symptoms were found to be statistically significant risk factors for determining the severity of the disease.

Conclusion: Various underlying disorders may present with torticollis. Vomiting, fever and dysphagia were alert symptoms of severe disease for patients with torticollis. Detailed history and careful systemic examination would contribute significantly to the prognosis of congenital and acquired torticollis.

Keywords: Child, Etiology, Torticollis, Sandifer syndrome