Benign paroxysmal torticollis (BPT) is a rare medical disorder affecting infants.
Symptoms
The defining characteristic of BPT is a tilting of an infant's head in recurrent episodes, for varying periods of time.
[Deonna, T. & Martin, D. (1981) Benign paroxysmal torticollis in infancy. Archives of Disease in Childhood. 56:956-959.] 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.
[Drigo, P. Carli, G. & Laverda, A.M. (2000) Benign paroxysmal torticollis of infancy. Brain and Development. 22:169-172.] In addition to this, the individual may also, but not necessarily, experience
vomiting
Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the Human nose, nose.
Vomiting can be the result of ailments like Food-poisoning, foo ...
,
pallor
Pallor is a pale color of the skin that can be caused by illness, emotional shock or stress, stimulant use, or anemia, and is the result of a reduced amount of oxyhaemoglobin and may also be visible as pallor of the conjunctivae of the eyes o ...
,
ataxia
Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements. Ataxia is a clinical manifestation indicating dysfunction of ...
,
agitation, infantile
migraine
Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
, unsteadiness of gait upon learning to walk, general
malaise
As a medical term, malaise is a feeling of general discomfort, uneasiness or lack of wellbeing and often the first sign of an infection or other disease. The word has existed in French since at least the 12th century.
The term is often used ...
and
nystagmus
Nystagmus is a condition of involuntary (or voluntary, in some cases) eye movement. Infants can be born with it but more commonly acquire it in infancy or later in life. In many cases it may result in reduced or limited vision. Due to the invol ...
.
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.
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.
Pathophysiology
The mechanism of action of benign paroxysmal torticollis is not yet understood.
[Eviatar, L. (1994) Benign Paroxysmal Torticollis. Pediatric Neurology. 11:72.] It has been suggested that unilateral vestibular dysfunction
or vascular disturbance in the brain stem
may be responsible for the condition.
Diagnosis
Diagnosis of BPT can be difficult because it is rare.
Treatment
No known treatment for BPT currently exists.
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.
However, some cases of benign paroxysmal torticollis cases can evolve into
benign paroxysmal vertigo of childhood, migrainous vertigo or typical
migraines
Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
.
History
The condition was first described by CH Snyder in 1969 in an article titled “Paroxysmal torticollis in infancy. A possible form of
labyrinthitis
Labyrinthitis is inflammation of the labyrinth – a maze of fluid-filled channels in the inner ear. Vestibular neuritis is inflammation of the vestibular nerve – the nerve in the inner ear that sends messages related to motion and position t ...
.” in the ''American Journal of Diseases of Children''.
References
External links
Orphanet: Benign paroxysmal torticollis of infancyN. Paul Rosman, Laurie M. Douglass, Uzma M. Sharif and Jan Paolini. J Child Neurol 2009 24: 155-160Sheikh Nigel Basheer (2010). "Paroxysmal torticollis". Journal of Pediatric Neurology 8 (2010) 69–71{dead link, date=October 2016 , bot=InternetArchiveBot , fix-attempted=yes
Episodic and paroxysmal disorders