What are the other Names for this Condition? (Also known as/Synonyms)

• BPT (Benign Paroxysmal Torticollis)

What is Benign Paroxysmal Torticollis? (Definition/Background Information)

• Benign Paroxysmal Torticollis (BPT) is an uncommon condition typically observed in infants and young children. The condition is marked by recurrent (often monthly) episodes of torticollis that remit spontaneously
• Torticollis is a muscular disorder that results in a twisted neck or a sideways tilted head, due to the neck muscles undergoing abnormal muscle contractions. It can be congenital or acquired
• According to ICHD classification, Benign Paroxysmal Torticollis is an episodic syndrome that may be associated with migraine
• Most cases of Benign Paroxysmal Torticollis are noted during the first 12 months following the birth of the child. The condition may be accompanied by pale appearance of skin, irritability, fatigue, and vomiting. In older children, BPT may also present loss of body movement control (ataxia)
• In some children, Benign Paroxysmal Torticollis may progress to benign paroxysmal vertigo or migraine with brainstem aura. However, in other children, the condition may resolve completely, and no further episodes may be noted

The criteria for diagnosis of Benign Paroxysmal Torticollis as outlined by the International Headache Society (IHS) is given below:

• Recurrent attacks in a young child, fulfilling criteria below
• Tilt of the head to either side, with or without slight rotation, remitting spontaneously after minutes to days
• At least one of the following five associated symptoms or signs:
  • Pallor
  • Irritability
  • Malaise
  • Vomiting
  • Ataxia
• Normal neurological examination between attacks
• Not attributed to another disorder

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)

Differential diagnosis to exclude the following conditions must be undertaken:

• Gastroesophageal reflux disease (GERD)
• Idiopathic torsional dystonia
• Complex partial seizure

Since, the condition may also be caused by congenital and acquired lesions in the posterior fossa and craniocervical junction of the brain, thorough neurological examination and/or radiological imaging studies are often required to determine the underlying cause.