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Concussion or Benign Paroxysmal Torticollis?

Reynolds, Ellen MSN, CRNP, CPNP PC/AC

Section Editor(s): Campo, Theresa M. DNP, APN, NP-C, CEN; Column Editor

doi: 10.1097/TME.0b013e318271fd97
Cases of Note

This case report describes a patient who presented to the trauma service on 3 occasions over the course of 2 years, each time with symptoms typical of concussion (e.g., crying, change in mentation, and vomiting). On more in-depth evaluation, it was discovered that the child had torticollis, pallor, and brief dizziness or vertigo with each episode. Benign paroxysmal torticollis is a periodic, paroxysmal syndrome that may be mistaken for the more common concussion. In addition to illustrating a uniquely pediatric neurological syndrome, this case demonstrates the importance of taking a careful history and considering a full range of differential diagnoses when evaluating every patient, even those with seemingly routine injuries.

Benedum Pediatric Trauma Program, Children's Hospital of Pittsburgh of UPMC; Robert Morris University; and University of Pittsburgh School of Nursing, Pittsburgh, PA.

CorrespondingAuthor: Ellen A. Reynolds, MSN, CRNP, CPNP PC/AC, Benedum Pediatric Trauma Program, Children's Hospital of Pittsburgh of UPMC, 416 Tierra Place, Pittsburgh, PA 15237 (

Disclosure: The author reports no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.