Nav: Home

What's the best treatment for positional plagiocephaly in infants? CNS publishes new guidelines

October 28, 2016

October 28, 2016 - Physical therapy--with helmet therapy if needed--is the recommended treatment for most infants with position-related flattening of the skull (plagiocephaly), according to a new set of clinical guidelines in the November issue of Neurosurgery, official journal of the Congress of Neurological Surgeons (CNS). The journal is published by Wolters Kluwer.

"Evidence-based guidelines for the treatment of positional plagiocephaly are necessary and important to deal with this common disorder," writes Dr. Ann Marie Flannery of Women's and Children's Hospital, Lafayette, La., and colleagues. An Executive Summary of the new guidelines is published in the November issue of Neurosurgery in addition to summaries of each individual chapter. The full-text versions of the guidelines are available on the Congress of Neurological Surgeons' Guidelines website.

Evidence-Based Recommendations for Diagnosis and Treatment of Positional Plagiocephaly

Positional plagiocephaly refers to flattening of one side of the head. It may occur in infants who always sleep in the same position, causing pressure on the same spot on the skull. This and other positional skull deformities have become more common since the recommendation to place babies on their backs to sleep. The "Back to Sleep" campaign (now called "Safe to Sleep") has been highly effective in lowering nationwide rates of sudden infant death syndrome (SIDS).

A multidisciplinary task force complied of clinical experts was assigned to perform a comprehensive review and analysis of the research on diagnosis and treatment of positional plagiocephaly. Developed by the Congress of Neurological Surgeons, these guidelines are also endorsed by the Joint Guidelines Committee of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons, and the American Academy of Pediatrics.

The new plagiocephaly guidelines include recommendations in the following areas:
  • Diagnosis. In most cases, positional plagiocephaly can be diagnosed by clinical examination. The guidelines include recommendations for further testing in situations where further information is needed.

  • Repositioning. Repositioning is an effective treatment for deformational plagiocephaly. However, available studies suggest that repositioning is inferior to physical therapy and helmet therapy.

  • Physical Therapy. Physical therapy is recommended over repositioning alone for infants aged 7 weeks and older. Physical therapy is recommended over the use of a positioning pillow in order to ensure a safe sleeping environment and comply with AAP recommendations.

  • Helmet Therapy. A helmet, or "cranial molding orthosis," is recommended for infants with moderate to severe plagiocephaly that persists after repositioning and/or physical therapy, or for older infants.

The recommendations in the new guidelines are rated according to the strength of the supporting research. The recommendation for physical therapy over repositioning aligns with the American Academy of Pediatrics' warning against the use of soft "positioning pillow" devices in the infants' sleeping environment.

The new documents offer guidance to the many different healthcare professionals--including pediatricians, neurosurgeons, neurologists, plastic surgeons, and physical therapists--who evaluate children with positional plagiocephaly. The guideline also highlights the need for continued research in several key areas, including further high-quality studies on the effectiveness of physical therapy.
-end-
Click here to read "Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for the Management of Patients With Positional Plagiocephaly."

Article: "Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for the Management of Patients With Positional Plagiocephaly" (doi: 10.1227/NEU.0000000000001426)

About Neurosurgery

Neurosurgery, the Official Journal of the Congress of Neurological Surgeons, is your most complete window to the contemporary field of neurosurgery. Members of the Congress and non-member subscribers receive 3,000 pages per year packed with the very latest science, technology, and medicine, not to mention full-text online access to the world's most complete, up-to-the-minute neurosurgery resource. For professionals aware of the rapid pace of developments in the field, Neurosurgery is nothing short of indispensable.

About Wolters Kluwer

Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.

Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).

Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization, visit http://www.wolterskluwer.com, follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.

Wolters Kluwer Health

Related Sleep Articles:

Short sleep duration and sleep variability blunt weight loss
High sleep variability and short sleep duration are associated with difficulties in losing weight and body fat.
Nurses have an increased risk of sleep disorders and sleep deprivation
According to preliminary results of a new study, there is a high prevalence of insufficient sleep and symptoms of common sleep disorders among medical center nurses.
Opioids are not sleep aids, and can actually worsen sleep research finds
Evidence that taking opioids will help people with chronic pain to sleep better is limited and of poor quality, according to an interdisciplinary team of psychologists and medics from the University of Warwick in partnership with Lausanne University Hospital, Switzerland.
Common sleep myths compromise good sleep and health
People often say they can get by on five or fewer hours of sleep, that snoring is harmless, and that having a drink helps you to fall asleep.
New evidence on the association of shortened sleep time and obstructive sleep apnea with sleepiness and cardiometabolic risk factors
A new study in the journal CHEST® may change the way we think about sleep disorders.
More Sleep News and Sleep Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...