Breastfeeding infants with congenital torticollis.

Infants with unilateral sternocleidomastoid tension and associated craniofacial, spinal, and hip asymmetries may feed poorly. Anatomic and muscular asymmetry stress both biomechanics and state control, increasing the potential for difficulty latching and sucking. A combination of positioning modifications to allow the infant to maintain his or her comfortable head tilt and turn, supportive techniques to restore alignment of oral structures, and handling techniques to help activate the weak contralateral muscles have been effective in the author's practice. Lactation consultants can promote positioning and muscle activation strategies and encourage physical therapy referrals for infants who do not respond promptly to reduce the risk of craniofacial deformity and developmental problems.

Concussion or benign paroxysmal torticollis?

This case report describes a patient who presented to the trauma service on 3 occasions over the course of 2 years, each time with symptoms typical of concussion (e.g., crying, change in mentation, and vomiting). On more in-depth evaluation, it was discovered that the child had torticollis, pallor, and brief dizziness or vertigo with each episode. Benign paroxysmal torticollis is a periodic, paroxysmal syndrome that may be mistaken for the more common concussion. In addition to illustrating a uniquely pediatric neurological syndrome, this case demonstrates the importance of taking a careful history and considering a full range of differential diagnoses when evaluating every patient, even those with seemingly routine injuries.

Professional nursing practice in neurology ambulatory care.

The ambulatory care setting is an important expanding area for professional nursing practice. The demand for ambulatory care nurses is stimulating the definition and development of professional nursing practices in outpatient clinics. Neurology ambulatory care at the National Institutes of Health, Bethesda, Md, is provided in the context of contributing to biomedical research. This article discusses the components of patient selection criteria, experimental therapy, and research data collection that have implications for nursing care. Visit categories are used to discuss administrative and practice issues of the research patient population at all institutes. Management plans are discussed, and a case study is presented along with a care plan.