TY - JOUR
T1 - Benign paroxysmal torticollis
T2 - phenotype, natural history, and quality of life
AU - Greene, Kaitlin A.
AU - Lu, Vivien
AU - Luciano, Marta San
AU - Qubty, William
AU - Irwin, Samantha L.
AU - Grimes, Barbara
AU - Gelfand, Amy A.
N1 - Funding Information:
Competing interests: M.S.L. has received consulting fees from Boston Scientific in 2019; receives grant support from NIH (NINDS, K23NS0099441-O1A), and receives personal compensation for medico-legal consulting. A.A.G. has received consulting fees from Theranica, Advanced Clinical, Biohaven, Impel Neuropharma, and Satsuma; has received honoraria from UpToDate (for authorship) and JAMA Neurology (as an associate editor); receives grant support from Amgen and the Duke Clinical Research Institute; has received personal compensation for medical–legal consulting (last in Jan 2019); her spouse reports research support (to UCSF) from Genentech for a clinical trial, honoraria for editorial work from Dynamed Plus, and personal compensation for medical–legal consulting. S.L.I. receives honoraria for authoring a chapter for the Canadian Pharmacy Association (CPhA) and research support from the Duke Clinical Research Institute. The remaining authors (K.A.G., V.L., W.Q., B.G.) have nothing to disclose.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
PY - 2021/11
Y1 - 2021/11
N2 - 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.
AB - 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.
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U2 - 10.1038/s41390-020-01309-1
DO - 10.1038/s41390-020-01309-1
M3 - Article
C2 - 33564129
AN - SCOPUS:85100798712
SN - 0031-3998
VL - 90
SP - 1044
EP - 1051
JO - Pediatric Research
JF - Pediatric Research
IS - 5
ER -