Botulinum toxin injection for congenital muscular torticollis presenting in children and adults.

Congenital muscular torticollis may present in late childhood or adulthood with cervical contractures, limited range of motion, pain, and muscular hypertrophy. Seven of eight pediatric and adult patients with congenital muscular torticollis were injected with botulinum toxin type A. Only two patients had a modest benefit with improved range of motion. Early recognition and treatment of congenital muscular torticollis is crucial to prevent subsequent contractures and other complications.