Home Introduction Prefaces Introduction to the classification How to Use This Classification Subcommittees and working groups The Classification Table of contents Part I: The primary headaches Part II: The secondary headaches Part III: Cranial neuralgias, facial pain and other headaches Appendix Definition of Terms

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A1. MigraineA1.1. Migraine without auraA1.2. Migraine with auraA1.3. Childhood periodic syndromes that are commonly precursors of migraineA1.3.4. Alternating hemiplegia of childhoodA1.3.5. Benign paroxysmal torticollisA2. Tension-type headacheA3. Cluster headache and other trigeminal autonomic cephalalgiasA6. Headache attributed to cranial or cervical vascular disorderA7. Headache attributed to non-vascular intracranial disorderA8. Headache attributed to a substance or its withdrawalA9. Headache attributed to infectionA10. Headache attributed to disorder of homoeostasisA11. Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structuresA12. Headache attributed to psychiatric disorderA13. Cranial neuralgias and central causes of facial pain

Description:

Recurrent episodes of head tilt to one side, perhaps with slight rotation, which remit spontaneously. The condition occurs in infants and small children with onset in the first year. It may evolve into 1.3.3 Benign paroxysmal vertigo of childhood or 1.2 Migraine with aura, or cease without further symptoms.

Diagnostic criteria:

Episodic attacks, in a young child, with all of the following characteristics and fulfilling criterion B:
1. tilt of the head to one side (not always the same side), with or without slight rotation
2. lasting minutes to days
3. remitting spontaneously and tending to recur monthly
During attacks, symptoms and/or signs of one or more of the following:
1. pallor
2. irritability
3. malaise
4. vomiting
5. ataxia¹
Normal neurological examination between attacks
Not attributed to another disorder

Note:

Ataxia is more likely in older children within the affected age group.

Comment:

The child's head can be returned to the neutral position during attacks: some resistance may be encountered but can be overcome.

A1.3.5 Benign paroxysmal torticollis may evolve to 1.3.3 Benign paroxysmal vertigo of childhood or 1.2 Migraine with aura (particularly 1.2.6 Basilar-type migraine).

These observations need further validation by patient diaries, structured interviews and longitudinal data collection. The differential diagnosis includes gastro-oesophageal reflux, idiopathic torsional dystonia and complex partial seizure, but particular attention must be paid to the posterior fossa and craniocervical junction where congenital or acquired lesions may produce torticollis.

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IHS vs. ICD-10

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