Tuesday, November 24, 2009

What is Benign Paroxysmal Torticollis of Infancy (BPTI)?

BPTI is an under recognized, self-limiting, benign disorder characterized by recurrent episodes of head tilt secondary to cervical dystonia (Snyder 1969). Attacks are often accompanied by vomiting, ataxia and pallor. Episodes occur without warning and with no specific triggering factors, although often with remarkable regularity. Episodes settle spontaneously, usually within a few hours, but may last upto 7 days only remitting in sleep. Episodes usually occur within the first 12 months of life and usually resolve by 5 years (but can be longer), occurring between 2 weeks and every 2 months. Infants may be hypotonic during an attack or have tortipelvis or an abnormal trunk posture.
There very frequently is a family history of migraine. There is of yet no treatment that helps. The disorder is almost certainly under-recognized by paediatric practioners, who often order extensive and unrewarding testing. Journal of Child Neurology/Vol.24, No.2 Feb 2009


Signs and Symptoms accompanying BPT:
· Limb Dystonia
· Vomiting
· Pallor
· Vertigo/ataxia
· Apathy/Drowsiness
· Gaze Abnormalities
· Early Gross or Fine Motor Delays
· Abnormal Audiometry

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