The types of pediatric squint include: postural squint, muscular squint, cervical spine deformity, and squint secondary to strabismus. The possible causes of myotonic squint include breech position, birth injury, etc.; congenital developmental malformation of cervical spine (such as hemivertebral malformation, etc.) leading to bony cervical scoliosis; head and neck deviation to reduce the discomfort of seeing objects caused by strabismus can also lead to squint. Why is pediatric myotonic squint congenital? Is there a genetic factor? Generally, myotrabismus can manifest itself in the postnatal or early postnatal period and can be associated with skeletal musculoskeletal disorders such as plantar inversion, developmental hip dislocation, and clubfoot. However, there are some cases of identical twins with myotuberculosis, so genetic factors are not completely excluded. What are the common causes of myotonic neck in children? There is no definitive answer to the exact cause of congenital myotonic neck in children. Associated factors may include: breech position, gigantic babies, birth injuries (delivery with forceps), infections, vascular injuries, etc. Can holding a baby or nursing in the same position for a long time cause myoclonus? Is this myelomeningocele? Holding the baby or nursing for a long time in the same position may cause the child’s head and neck to be tilted to one side. The characteristics of this kind of “squint” are: it is mostly seen in small babies less than 2 months old, at this stage of development, the baby’s neck muscles are not yet well developed and cannot control the head and neck posture well; the head tilt is often not fixed in one direction, i.e. the child can tilt the head to the opposite side normally, but most of the time to one side; the sternocleidomastoid muscle is usually not tense, and the head and neck can be turned passively. The sternocleidomastoid muscle is usually not tense, and there is no restriction in the passive rotation of the head and neck; it will improve naturally as the baby develops and the mother changes the habit of holding the child. How to distinguish whether myotonic squint leads to strabismus or strabismus leads to strabismus? In congenital myotonic strabismus, there is usually a palpable mass formation or tension in the sternocleidomastoid muscle in the neck, and the active and passive movement of the head and neck is limited. In contrast, in strabismus, the head and neck deviation is obvious when the child looks at the object, and there is no obvious mass or restriction of movement in the neck. A simple and easy way to distinguish between the two is to cover one of the child’s eyes with something (for more than 10 minutes) and see if the child’s head and neck deviation improves on its own. If the head and neck deviation improves significantly after covering one eye, you can initially determine that the problem is caused by strabismus. You can take your child to an ophthalmologist to further clarify the diagnosis.