Benign paroxysmal torticollis is a neurological disorder that does not require treatment and is self-limiting. However, it is important that it is correctly diagnosed, because the characteristic tilting of the head by a child may also have other reasons.

Benign paroxysmal torticollisis a rare disorder that occurs in infants and young children up to the age of 5, mostly in girls. Its etiology is not fully known, but it is suspected that it may be a type of migraine. Many childhood episodes of mild paroxysmal torticollis suffer from migraines in their adult lives. It is also worth adding that this disorder usually runs in families. What else do we know about benign paroxysmal torticollis in children? Perhaps the labyrinth is responsible for the development of this symptom, because motion sickness often goes hand in hand with torticollis. Torticollis can also be the first stage of paroxysmal dyskinesia, a condition characterized by brief episodes of involuntary movements.

Symptoms of mild paroxysmal childhood torticollis

At first glance, torticollis can be recognized by the lateral tilt of the head and the rotation of the chin in the opposite direction to this tilt. Such a situation can occur in a few months old baby and without any announcing signals - suddenly, i.e. paroxysmal as the name suggests. Sometimes it lasts for a while, a few minutes, an hour, but sometimes it lasts for days and repeats itself several times a month. In addition, the following may occur:

  • vomiting
  • ataxia (disturbances in body coordination, usually one-sided)
  • pallor
  • unilateral muscle hypotension (muscle weakness)
  • photosensitivity, tearing of one eye
  • apathy, sleepiness
  • general malaise, irritability

Attempts to "straighten" the child's head cause him pain and crying.

Diagnosis of benign paroxysmal torticollis in children

The characteristic feature of this disorder is that the neurological tests performed between bouts of torticollis give correct results. And because the condition is mild, temporary and uncomplicated, invasive testing is not recommended.

Only if there is a suspicion that we are dealing with a disease other than benign paroxysmal torticollis - e.g. a tumor in the back of the skull,paralysis of the external muscles of the eyeball, Sandifer's syndrome, or epileptic seizures, which may cause similar symptoms - diagnostics should be extended. Then it executes:

  • imaging examinations of the head and cervical spine (computed tomography, magnetic resonance imaging)
  • electroencephalogram (EEG)
  • ophthalmological examinations
  • ENT examinations

What to do if your child has mild paroxysmal torticollis

You should definitely not put the baby in the correct position and straighten it by force, but you can do a gentle massage on your own. A small child is irritated by what is happening to his body, because he cannot, for example, reach for toys or hold them in his hand. It is then necessary to help him and facilitate various difficult activities. If torticollis is accompanied by pain, we give painkillers. The first episode of torticollis must be reported to a pediatrician in order to exclude another disease. The doctor will also order a neurological consultation.

Prognosis

Benign paroxysmal torticollis is a disorder that cannot be treated. It resolves spontaneously before the child is 5 years old. While at first the bouts of torticollis may be frequent and intense, over time they will become less frequent and less painful. Unfortunately, the patient may develop migraines later in life.

Category:

Neurology