Great Dunmow Osteopathic Clinic

Plagiocephaly

Monday, November 30, 2009

Plagio ( Greek word for twisted)  cephalic ( Greek word for Head)

 

All parents want the very best for their children and if your baby has a flattened head the first thing to do is to get a diagnosis to ensure the issue can be dealt with effectively.

 

 

Plagiocephaly is caused in three mains ways:

 

1) Plagiocephaly synotosis. This is where one or more of the sutures in your babies skull has prematurely ossified. It is the least common cause of plagiocephaly  but not that uncommon and it needs early diagnosis to prevent time and money spent on unnecessary and futile treatments.  In most cases it can be clinically diagnosed by trained health professionals without the use of X -ray, however, in some difficult cases X-Ray or CT scan will be necessary to make the correct diagnosis.

 

If a diagnosis of synostosis is made then you will be referred to a neurosurgeon for consultation as how to remedy the issues with this  problem.

 

2) Plagiocelaphy due to external forces;

 

Examples of external forces:

• Birth trauma
• Hydrocephalus
• Perinatal Obstetrical intervention
• Torticollis

Other risk factors that can associate to Plagiocephaly:

• Prematurity
• Motor Development delay
• Positional Preference
• Ocular conditions
• Auditory conditions
• Scolliosis of infancy
• Limited abduction in the contra lateral hip and foot anomolies

 

This means if your baby has any of the above seek an appointment and get checked by an appropriate trained health professional.

 

In this type of plagiocephaly all the sutures are there and healthy but the head has become misshapen early action is required for best results.

 

If your baby has any of the above risk factors in its history get your baby checed by an appropriate health professional who has accurate knowledge in order to advise you correctly. 

 

3) Plagiocephaly due to gravitational forces:

 

Babies due to evidence generated by research into SIDS( Sudden Infant Death Syndrome)  should always sleep on their backs .

 

A complication of this ,however, is that your baby may develop some flattening of the back of its head.

In the main this can easily be remedied by regular repositioning whilst baby is asleep. When your baby is awake  lay him or her on their tummy to help baby develop spinal extensors, shoulder girdle strength/ control and head holding strength.

 

 

 

The question' why bother doing anything?'.... if it is essentially only cosmetic. There are two main reasons that have been highlighted:

 

1). Unfortunatley we still live in a society that has great difficulty in accepting things that look different. Society is viciously cosmetically prejudice; ask any school child teenager read HEAT magazine. It takes an incredibly strong child to suffer the sort of bullying which will sadly inevitably happen and not bear psychological scars as an adult.

 

2)The Guilt that parents experience when they find out too late that they could have done something for their child if they had known early enough.

 

3) The NHS are not funded to treat Plagiocephally due to NICE not having done due diligence on the evidence available so you will get the stock answer from your GP unless he  or she is switched on is that baby will grow out of it by 24months. Lots of babies do grow normalise their head shape, but lots don’t either and it is those babies that can and should be helped as early as possible when things can be done. Unfortunately Paediatrians and neurosurgeons will take a similar line as the GP unless they have a particular interest in the condition.

One has to remember that treatment is only ever offered and the choice to go forward with treatment lays with the childs parent legal guardian until the child is 18.

 

 

How do we manage plagiocephaly?

 

 

• 0 - 4-5 months Cranial Osteopathy, Repositioning, Physical theray.
  These treatment are accessable, non invasive and conservative. For example a course of cranial osteopathy costs approximately £200.00, this will cover all aspects of self help repositioning as well as treatment itself.
• With no or little change then helmet therapy from 5 months to 14months has excellent results in reshaping the head. Treament will not be started after 14 months as the clinicians do not feel there is enough movement in the vault to give enough benefit for the cost of the treatment. They only treat severe plagiocephaly that is defined as a cranial index being 12 percentage points over the normal.
• ( normal being a value of 78- it is a ratio value of the width of your childs' head over the length) If your baby falls with in the criteria for helmet therapy it will be successful and the treatment costs £1995.00.