engleski

Benign paroxysmal transitory torticolis in infants – the presentation of thirteen patients

Benign paroxysmal transitory torticolis (BPT) is a disorder which manifests with repetitive episodes of abnormal rotations and head leaning on one side (torticolis) often associated with asymetric posturing (tortipelvis), contraction of muscles on the back side of neck (retrocolis) or generalized hypotonia. Attacks always begin in infant period and last for several hours or days (and up to two weeks). They are repeated themselves in weekly or monthly intervals. Prognosis of BPT is favourable and attacks spontaneously disappear till the school age. Our patients: During the period of fifteen years (1993 – 2008.g.) in our clinics we diagnosed and surveyed clinically 13 children with BPT (7 boys, 6 girls). Most children were referred to the initial neuropediatric evaluation under the suspicion of convulsive/epileptic seizures. Clinical expression of BPT in our patients was typical, without loss of consciousness. EEG findings in all children were normal, and they had normal psychomotor development. Average age of first BPT attacks was 5 months. Frequency of attacks was from 1 to 41 in different intervals and duration of attacks from 1-2 minutes up to 7 day. In one boy BPT attacks first were diagnosed in another hospital as epileptic – partial complex seizures and he was treated unsuccessfully with phenobarbital. The boy is now at the age of 6 years and 8 months , he still suffers from rare attacks of torticolis in duration of couple hours which are accompanied by intensive headaches with vomiting and general prostration that points to the relationship between BPT and migrene. Diagnosing of BPT as the paroxysmal non-epileptic disorder in infants and children is based on clinical features of attack (preserved consciousness, lack of tonic or tonic/clonic seizures), duration of attacks up to several days (weeks) and normal finding of ictal and interictal EEG.

benign paroxysmal transitory torticolis ; infant

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