KISS syndrome

According to Décret n°2007-435 du 25 mars 2007 on the acts and conditions of practice of osteopathy, it is stipulated in the Chapitre 1er : Actes autorisés, Article 3, Alinéa II  :

After a diagnosis made by a doctor attesting to the absence of a medical contraindication to osteopathy, the practitioner with an osteopath title is authorized to perform the following acts:

• Manipulations of the skull, face and spine in infants under six months of age;
• Manipulations of the cervical spine.

Before any osteopathic treatment in our office and in the absence of a prescription issued by another doctor, Dr. Serge LARCHER after thorough examination of the patient establishes a certificate of non-contra-indication medical osteopathy to be in adequacy with the legislation in force.

This is generally accounted for by a lack of knowledge of the syndrome and the fact that it is confused with a congenital torticollis. Health professionals who have never heard of this disorder trivialize or dramatize the situation. This leads to the completion of multiple complementary exams or even hospitalization. Faced with poor results, parents’ anxiety increases.

Moreover, this syndrome is not taught in French osteopathic schools. It is therefore quite normal that our colleagues unfortunately do not have not so far the actual knowledge concerning the syndrome and its management. In the presence of these symptoms, they rightly treat all the tensions they can find on the child, but these are the consequence and not the cause of the disorder.

The treatment of KISS syndrome involves several steps that must be followed in order to achieve lasting results over time.

There is therefore often transient improvement of the child's symptoms but a rapid relapse occurs after few weeks because of the persistence of the injury of the cranio-cervical junction.

No, neither mom nor dad is responsible for the condition of their child. Parents are themselves victims of this situation that they cannot deal with and not responsible for it.

KISS syndrome has multiple causes: a stressful course of pregnancy, a twin pregnancy and also, a bad uterine position or difficulties at birth such as cord around the neck, cesarean section, a rapid or long birth, the use of forceps or cupping, pressure on the belly of the parturient to facilitate the descent of the baby, the weight of the baby, over 4 kg, etc.all these factors are possible causes of the occurrence of this syndrome.

Difficult to answer. Today in France, very few professionals are experienced and trained in this treatment. Indeed, the therapeutic management of a syndrome of KISS requires a specific knowledge of the latter, a precise diagnosis as well as a particular technicality.

In our office, each consultation is performed in pairs: a doctor and an osteopath.

As soon as possible, in order to avoid the accumulation of secondary adaptations.

"As little as possible, as much as possible, and at the right time. "

Heiner Bidermann

An "osteopathic manipulation" is a manual gesture that, by definition, makes it possible to restore mobility to a joint in the respect of physiology.

We take, beforehand, all the necessary precautions in order to find out pathologies if any that could possibly be a counter indication to the manipulation.

Before the first appointment parents are handed over :

• a health questionnaire
• an order to perform a radiological assessment of the cervical spine and the pelvis.

On the first session complete clinical examination is performed. Further explorations will be conducted if and when needed.

No, no way!

During the osteopathic session, the child is often crying, not for the pain, but simply because he does not generally appreciate being manipulated by strangers. Releasing tissue tension during handling can also cause crying.

The manipulation of the cranio-cervical junction, is performed by a thrust technique called HvBa (High Velocity and Low Amplitude). It aims at impulsing a very fast movement whose amplitude is very low which allows the respect of the articular physiology.

Laurie S.HARTMAN in the Manual of Osteopathic Techniques 1 states that in a thrust technique "with sufficient velocity, articular decoaptation can be achieved even within the median limits of joint amplitude without any trauma being induced. "

[1] HARTMAN Laurie S., Manuel des Techniques Ostéopathiques, OMC éditeur, collection SBO.

After more than 2000 children taken care of since 2011, we noticed the following 3 reactions in the 48 hours following the session:

• The child is calmer, sleeps more and looks less tense,
• There is no change or difference in the child’s behavior,
• The child may have a neuro-vegetative reaction secondary to treatment, manifested by:
  worsening of symptoms, or the onset of reflux and / or vomiting,
  tears,
  perspiration,
  an agitation or on the contrary a great fatigue.

These reactions are perfectly normal and not serious. They are linked to a defense reaction of the body, the same type of reaction is observable following a vaccination for example. Once the information is assimilated by the tissues, the symptoms disappear spontaneously and the child's condition improves day by day.

The undiagnosed child therefore not treated, will continue its development around this dysfunction of the cranio-cervical joint.

Key point of postural unbalance, children can present various difficulties of development and acquisition:

• Posture disorders,
• Delay and / or teething problems,
• Delay in maintaining the sitting position,
• Delay and / or difficulty crawing,
• Delay and / or difficulty learning to walk,
• Delay and / or difficulty in language learning,
• Socialization disorders,
• Scoliosis development,
• Headaches and / or migraines,
• Badly chronic and unexplained,

The above list is neither well understood nor systematic. Each person having a reaction and an adaptation mechanism of his own.

In the first session, the KISS syndrome, in other words the blockage of the cranio-cervical junction, is in itself definitely cured.

A new trauma only can generate a relapse of this lesion. This will require a new manipulation.

The KISS syndrome, however, generates a number of times and depending on the case, more or less complications (acquisition and development) that can evolve for each case in different ways.

Some children may require a more comprehensive care: Osteopathy, physiotherapy, speech therapy, psychomotricity... An annual osteopathic check is recommended, as it is for any child.

Before treatment and to rule out any other condition, we ask for radiographic examinations requested (see protocol of care). These are not dangerous for your child.

X-ray exposure, especially in children under 1 year of age, is estimated at 0.35 millisievert while natural radiation averages 2.5 millisieverts * or 8 times more.

* millisievert is a unit measuring radiation exposure.

IRSN report: Exposure of the French population to ionizing radiation related to medical diagnostic acts in 2012

Our work does not, to date, eliminate a genetic factor to KISS syndrome. Some cases of familial KISS syndrome are sometimes related only to an imbalance of the mother's pelvis. Preventive osteopathic treatment of the latter makes it possible to avoid recurrences.