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The Neurology of Benign Paroxysmal Torticollis of Infancy: Report of 10 New Cases and Review of the Literature

Departments of Pediatrics and Neurology, Division of Pediatric Neurology, Boston Medical Center, Massachusetts, Tufts Medical Center, Boston, Massachusetts, npaul.rosman{at}bmc.org

Laurie M. Douglass, MD

Departments of Pediatrics and Neurology, Division of Pediatric Neurology, Boston Medical Center, Massachusetts, Tufts Medical Center, Boston, Massachusetts

Uzma M. Sharif, MD

Tufts Medical Center, Boston, Massachusetts, Children's Hospital of Wisconsin, Milwaukee, Wisconsin

Jan Paolini, RN, PNP

Tufts Medical Center, Boston, Massachusetts, Massachusetts General Hospital, Boston, Massachusetts

Benign paroxysmal torticollis is an under-recognized cause of torticollis of early infancy. The attacks usually last for less than 1 week, recur from every few days to every few months, improve by age 2 years, and end by age 3. There very frequently is a family history of migraine. We did a detailed analysis of 10 cases of benign paroxysmal torticollis, seen over 5 years, and compared our findings with those in the 103 cases in the literature. Detailed neurodevelopmental assessments, available only in our cases, showed accompanying gross motor delays in 5/10 children, with additional fine motor delays in 3/5. As the benign paroxysmal torticollis improved, so did the gross motor delays in 3/5, and the fine motor delays in 1/3. In all of our cases, at least 2 other family members had migraine. Benign paroxysmal torticollis is likely an age-sensitive, migraine-related disorder, commonly accompanied by delayed motor development.

Key Words: torticollis • paroxysmal • migraine • motor development

Journal of Child Neurology, Vol. 24, No. 2, 155-160 (2009)
DOI: 10.1177/0883073808322338


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