positional plagiocephaly
about condition
Positional plagiocephaly (also called flat head syndrome) is the flattening or molding of an infant’s skull due to prolonged contact with external surfaces. It usually becomes noticeable at two to three months of age. The condition is also referred to as abnormal head shape or flat head.
There are two main types:
- Occipital plagiocephaly – the head shape resembles a parallelogram, with the ear positioned forward on the same side as the flattening.
- Brachycephaly – flattening occurs across the entire back of the head.
symptoms
Factors and signs associated with positional plagiocephaly may include:
- Flattened area on the skull (often visible by 2–3 months of age)
- Asymmetrical head shape (parallelogram appearance in occipital plagiocephaly)
- Ear shifted forward on the flattened side
- Broad, short head shape in brachycephaly
- Possible associated torticollis (tightness of neck muscles)
- Developmental delay may be present in some cases
diagnosis
Physicians typically identify plagiocephaly through a physical exam.
- A thorough examination can also detect associated torticollis.
- In some cases, ultrasound or X-ray may be used to confirm the diagnosis.
- Early referral to a neurosurgeon is important, as the most rapid head growth occurs in the first 6–12 months.
treatments
- Physical therapy when torticollis is present
- Repositioning techniques (changing head position frequently, supervised tummy time)
- Helmet therapy for moderate to severe cases (usually only considered before 12 months of age)
- Early intervention improves cosmetic outcome
faqs
Here are some common questions about positional plagiocephaly:
Before 1992, about 1 in 300 infants were affected. With the introduction of “Back to Sleep” guidelines, incidence has risen to as high as 1–2 in 10 infants.
Most cases develop after birth due to external positioning, not during pregnancy.
The condition does not affect life expectancy.
through a physical exam, sometimes supported by imaging (ultrasound, X-ray).
Through repositioning, tummy time, and in more severe cases, helmet therapy.
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