Yadegari reports a narrative literature review for abnormal head postures (AHPs) with discussion on different causes. This review summarises the control of a normal head posture before discussing differences of ocular vs non-ocular AHPs. Ocular AHPs may be adopted to optimise visual acuity, maintain binocular single vision or centre a narrow visual field. The clinical features that underpin ocular AHP that can aid differential diagnosis from non-ocular causes are outlined, e.g. AHP developing after 18 months of age, lack of stiffness of the sternocleidomastoid muscle, improvement when eyes are closed and increased deviation angle when the AHP is straightened. Pathophysiology of ocular AHP is classified into four groups of misalignment, nystagmus, ptosis and refractive errors. Non-ocular AHP is categorised into two groups of congenital and acquired, with congenital involving muscular or skeletal issues and acquired including traumatic or non-traumatic causes (trauma with injuries to muscles, bones, ligaments or the brachial plexus – non-traumatic causes in four categories of musculoskeletal causes, neurologic causes, otolaryngologic causes and miscellaneous, e.g. side-effects of medications).
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Causes of abnormal head postures – literature review
Reviewed by Fiona Rowe
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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