[Benign paroxysmal torticollis. Our experience gained over a 15-year period]

Benign paroxysmal torticollis (BPT) is characterised by recurring episodes of lateral bending of the neck, occasionally accompanied by vegetative symptoms, ataxia or an abnormal position of the trunk, with a tendency to disappear spontaneously after some months or years, and with no alterations between episodes.

To analyse the clinical and developmental characteristics of the cases evaluated by the Neuropaediatric Service at our hospital that were classified as BPT.

We reviewed the history of the patients with BPT included in the Neuropaediatric Service database over a 15-year period. Patients who were not following any kind of control were contacted by telephone.

We found 13 BPT patients with typical criteria, and 4 others with possible BPT (p-BPT), because they had had an isolated episode of torticollis. Neuroimaging was carried out in nine children (69.2%) from the BPT group: this included only transfontanellar ultrasound recording (TF USR) in six cases, TF USR and computerised axial tomography (CAT) in one child, only a CAT scan in one case, and CAT and magnetic resonance imaging in another. Neuroimaging was performed in all the cases of p-BPT: CAT scans were carried out in two cases and TF USR was used in two others.

Atypical cases can be excluded by establishing a diagnosis of BPT with strict criteria. Since no biological markers are available, the diagnosis must be based on the clinical pattern and course and, in some cases, complementary examinations have to be performed to preclude other pathologies. When a child is diagnosed with BPT, the family needs to be reassured and told that it is a benign process with a tendency to disappear spontaneously.