1.6.3 Benign paroxysmal torticollis

A 16-month-old boy has had recurrent episodes, on approximately ten occasions since he was eleven months old. In each episode his head tilts firmly to one side, alternating between left and right on different occasions, and he becomes noticeably irritable and difficult to console throughout. The episodes typically run their course over half a day to just over a day, resolving completely without any intervention, and he does appear to have a headache during these times, judging by his behaviour. Between episodes he is a cheerful, sociable toddler with no concerns raised at his recent developmental review. Assessment well removed from any episode found him to be neurologically entirely normal, with appropriate tone, reflexes and coordination for his age; I have, however, never had the opportunity to examine him during one of the episodes themselves, and there remains no other underlying disorder to account for his presentation.