Benign paroxysmal torticollis: phenotype, natural history, and quality of life
- 9 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Pediatric Research
- Vol. 90 (5), 1044-1051
- https://doi.org/10.1038/s41390-020-01309-1
Abstract
Background Benign paroxysmal torticollis (BPT) is characterized by attacks of head tilt associated with vomiting, irritability, and/or ataxia in early childhood. BPT is associated with migraine but risk factors are unknown. Impact on quality of life is also unknown. Methods Parents/caregivers of children with ongoing or resolved BPT participated in telephone interviews (n = 73). Those with ongoing BPT completed the Infant Toddler Quality of Life questionnaire (ITQoL). Results Median age of children at the time of interview was 2.9 years (range 0.25–23). BPT was ongoing in 52% (n = 38). Nineteen percent (n = 14) developed migraine (median age 9.25 years, range 2.5–23) and 63% (n = 46) developed another episodic syndrome associated with migraine. Proportion of patients who developed migraine was higher among those with certain migrainous symptoms during BPT attacks vs. those without: phonophobia (58 vs. 21%, p = 0.02), photophobia and phonophobia (55 vs. 23%, p = 0.05), and photophobia, phonophobia, and motion sensitivity (60 vs. 22%, p = 0.02). ITQoL results showed significant impact of BPT on quality of life. Conclusions Children with BPT may develop migraine or other episodic syndromes associated with migraine. Presence of migrainous features during BPT episodes may increase likelihood of developing migraine. Though characterized as “benign,” BPT can significantly impact children and families. Impact Benign paroxysmal torticollis (BPT) is a rare condition of early childhood characterized by episodes of head tilt associated with vomiting, irritability, ataxia, pallor, and/or malaise. This cohort study describes the phenotypic spectrum of BPT, variable treatment, natural history and association with migraine, and impact on development and quality of life. Children with BPT may go on to develop migraine or episodic syndromes that may be associated with migraine; presence of migrainous features during attacks may increase odds of developing migraine. BPT can have significant impact on quality of life, demonstrated by findings from the Infant Toddler Quality of Life questionnaire.Keywords
This publication has 25 references indexed in Scilit:
- Familial PRRT2 mutation with heterogeneous paroxysmal disorders including paroxysmal torticollis and hemiplegic migraineDevelopmental Medicine and Child Neurology, 2012
- Parent-reported health outcomes in infants/toddlers: measurement properties and clinical validity of the ITQOL-SF47Quality of Life Research, 2012
- Migraine prevalence by age and sex in the United States: A life-span studyCephalalgia, 2010
- The Neurology of Benign Paroxysmal Torticollis of Infancy: Report of 10 New Cases and Review of the LiteratureJournal of Child Neurology, 2009
- Genetic Analysis of 27 Spanish Patients with Hemiplegic Migraine, Basilar-Type Migraine and Childhood Periodic SyndromesCephalalgia, 2008
- Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics supportJournal of Biomedical Informatics, 2008
- Benign paroxysmal torticollis of infancy: four new cases and linkage to CACNA1A mutationDevelopmental Medicine and Child Neurology, 2002
- Benign paroxysmal torticollis of infancy: four new cases and linkage to CACNA1A mutationDevelopmental Medicine and Child Neurology, 2002
- Systematic review of the occurrence of infantile colic in the communityArchives of Disease in Childhood, 2001
- Benign paroxysmal torticollis in infancyArchives of Disease in Childhood, 1981