A 7-month-old with 'loss of muscle control

Clinical introduction

A 7-month-old male was brought to the emergency department for episodes of right sided lateral neck flexion occurring over the last day. His mother reported a similar episode a month prior where the boy also experienced right sided torso arching with an episode of vomiting.

His past medical history was unremarkable and was developing appropriately. Family history was significant of migraine headaches on the father's side.

His mother captured a video of one of the episodes (see ).

Question

What is the most likely diagnosis?

Spasmus Nutans

Infantile Spasm

Benign Paroxysmal Torticollis

Sandifer Syndrome

Answer: C

The video and clinical history are most suggestive of Benign Paroxysmal Torticollis (BPT). BPT is an idiopathic disorder characterised by periodic lateral flexion of the neck during which the child is conscious and responsive, first described in 1969 by Snyder and Harrison.

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