Benign paroxysmal torticollis

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Benign paroxysmal torticollis (BPT) is a rare medical disorder affecting infants. [1]

Contents

Symptoms

The defining characteristic of BPT is a tilting of an infant's head in recurrent episodes, for varying periods of time. [1] [2] Furthermore, the child's trunk may bend in the same direction as the head, giving the baby an overall curved shape; this complaint is known as tortipelvis. [1] [2] In addition to this, the individual may also, but not necessarily, experience vomiting, pallor, ataxia, agitation, infantile migraine, unsteadiness of gait upon learning to walk, general malaise and nystagmus. [1] [2]

The periods in which the child's head is tilted and other symptoms appear can last anywhere from a few minutes to a few weeks, with a frequency of anywhere from two per year to two per month. [1] [2]

Causes

The cause of benign paroxysmal torticollis in infants is thought to be migrainous. More than 50% of infants have a family history of migraine in first degree relatives. The cause is likely to be genetic. [1] [2]

Pathophysiology

The mechanism of action of benign paroxysmal torticollis is not yet understood. [1] [2] [3] It has been suggested that unilateral vestibular dysfunction [3] or vascular disturbance in the brain stem [1] may be responsible for the condition.

Diagnosis

Diagnosis of BPT can be difficult because it is rare. [3]

Treatment

No known treatment for BPT currently exists. [1] However, the condition it is self-limiting and resolves after about eighteen months.

Prognosis

Benign paroxysmal torticollis disappears in the early years of life with no medical intervention. [1] [2] [3]

However, some cases of benign paroxysmal torticollis cases can evolve into benign paroxysmal vertigo of childhood, migrainous vertigo or typical migraines. [1] [2]

History

The condition was first described by CH Snyder in 1969 in an article titled “Paroxysmal torticollis in infancy. A possible form of labyrinthitis.” in the American Journal of Diseases of Children. [1] [2] [3]

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References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 Deonna, T. & Martin, D. (1981) Benign paroxysmal torticollis in infancy. Archives of Disease in Childhood. 56:956-959.
  2. 1 2 3 4 5 6 7 8 9 Drigo, P. Carli, G. & Laverda, A.M. (2000) Benign paroxysmal torticollis of infancy. Brain and Development. 22:169-172.
  3. 1 2 3 4 5 Eviatar, L. (1994) Benign Paroxysmal Torticollis. Pediatric Neurology. 11:72.