Plagiocephaly (Flat head syndrome)

Plagiocephaly is a term used to describe asymmetrical head shape.

Deformational plagiocephaly (also known as positional or non-synostotic plagiocephaly) is used to describe asymmetrical head shape as a result of head preference to one side. This should be differentiated from craniosynostosis, a rare cause of head shape asymmetry, which is caused by early fusion of sutures.

What causes deformational plagiocephaly?

Deformational plagiocephaly is caused by an external force consistently to a specific region over a long period.

This creates increased pressure to one side of the head.

The area most often affected in the posterior occiput (back part of the head).

There has been an increased incidence of since the introduction of the back to sleep program [1].

There are numerous possible causes of head preference. These include common conditions such as torticollis, conditions that must be considered with each patient (such as eye and neurological conditions), and rare conditions.

In each patient, the rare condition craniosynostosis (fused sutures) must be ruled out.

What are the effects of plagiocephaly?

Plagiocephaly leads to characteristic head shape changes, with flattening on one side at the back of the head, shift in ear position, and changes to facial shape. Various measurement systems are used to assess and monitor shape.

Previously this problem was considered simply cosmetic, however, the neurological effects in deformational plagiocephaly are becoming more established in the literature, with effects related to head control [2, 4], cognitive, language, learning and attention [3, 5], motor development [6-8], auditory development [9], developmental delays [10], visual fields [11], and muscle tone [12].

For example, in 2000 Miller et al [5] looked at a group of children with head asymmetry, finding that 39.7% required special help in primary school in areas relating to language disorders, learning disability and attention deficits. In comparison 7.7% of siblings required special help.

In 2001 Panchal et al [6] looked at early (mean age 8 months) motor and cognitive development in those with deformation plagiocephaly, finding 33% with delayed motor and 17% with delayed cognitive development.

In 2002, Balan et al [9] identified abnormal central sound processing in plagiocephalic infants using electrophysiological measures (ERP’s), placing these infants at an elevated risk of auditory processing disorders.

A 2005 study by Siatkowski et al [11] found visual field defects of 20 degrees or more in 35% of infants tested. 12% of the infants in the same study had delayed development of milestones.

In another study in 2007 [3] further information about learning issues was obtained, with thirty-three percent of infants with plagiocephaly requiring learning assistance, and 14% were in a special class.

1996 [2], 2008 [12], 2009 [7] , and 2011 [10] studies have shown abnormal head control, muscle tone and motor development in those with plagiocephaly.

Importantly, the Miller study found that helmet therapy does not change neurological outcomes in plagiocephaly, and in the Siatkowski study the severity of skull asymmetry was not linked to severity of visual field defects.

This indicates that other factors other than modified skull form must be affecting neurological outcomes.

What is the typical Chiropractic process?

Chiropractic management at this clinic involves a thorough discussion (history) to identify the important issues. This is followed by a thorough examination, including assessments of head shape, neurological function, and body function. The recommended management is based on the findings in each individual situation. Regardless of any specific condition, Paediatric Chiropractic allows normal function, thus contributing to normal nervous system and musculoskeletal development.

How to book a consultation with our chiropractors.

Contact our Berwick or Cowes practice to make an appointment.

We provide care for infants/toddlers, children, adults, and throughout pregnancy