Quiz Form

Question Date: 07/02/2024

Question: A 2-month-old was evaluated by his pediatrician for intermittent episodes of forced head turns to the left. Each time, the event lasts for approximately 6 hours but is not associated with any distress to the infant. There are no abnormal movements of the eyes or limbs. What should the advice be to the parents at this time?

Options:

• The child will likely outgrow these episodes
• The child will likely need antiepileptics to help attenuate these episodes
• The child needs a trial of ranitidine to decrease gastroesophageal reflux
• This is part of normal development for the child.

Correct Answer: The child will likely outgrow these episodes

Explaination: The child likely has benign paroxysmal torticollis in infancy. This is an idiopathic condition characterized by periods of cervical dystonia that begin and end suddenly lasting for a few hours to a few days. During this time, the child is usually alert and responsive without other adventitious movements of the arms or legs. Occasionally these movements can be accompanied by vomiting, pallor, irritability, or ataxia. Some consider paroxysmal torticollis in infancy to be a migraine equivalent, and a relationship with the CACN1A gene, which is linked to familial hemiplegic migraine, has been discovered in some families. This condition is self-limiting and almost always disappears by 5 years of age. Spasmus nutans is associated with cervical dystonia, but should also havenystagmus and head nodding.

Reference: ( Bradleys NiCP, 7th edn, Ch. 103, pp. 16861719).