- Head banging (HB) is defined as the hitting of head on solid object such as a wall, side of crib, mattress, or floor.
- Tend to hit the front or side of the head
- Usually last for 15 minutes but can go on for >1 hour
- Regular rhythm of 60 to 80 bpm
- Can be seen along with body rocking or head rolling
- Average age of onset is 9 months; usually extinguished by 3 years of age
- Older patients with HB are more likely to have a developmental delay or other medical problems.
- More common in boys than girls (3:1)
- Occurs in 3–15% of typically developing children
- Estimated that 2–3% of kids with intellectual disability have stereotypic movement disorder (SMD) (HB) and 5% of kids with Tourette syndrome have SMD (HB)
- Can be comforting and be a part of other self-soothing activities such as body rocking or head rolling
- Can be seen during a temper tantrum secondary to frustration or anger
- Can be seen with typically developing children as an expression of happiness or as a method of self-stimulation (sometimes secondary to sensory deprivation)
- Need to rule out medical causes specifically if HB occurs suddenly and is associated with other symptoms
- Can be part of a sleep rhythmic disorder called Jactatio capitis nocturna (partial arousal during light, non-REM sleep); HB occurs when drowsy or falling asleep.
- Can be described as SMD, which is a repeated, rhythmic, purposeless movement or activity; these usually cause self-injury or severely interfere with normal activities. These are most prevalent in adolescence and tend to occur in clusters of symptoms. Diagnosis requires 4 weeks of duration.
Commonly Associated Conditions
- Medical causes:
- Teething (pain)
- Ear infection
- Drug use (cocaine, amphetamines)
- SMD associated with:
- Cerebral palsy
- Intellectual disability
- Autism spectrum disorders
- Down syndrome
- Lesch-Nyhan syndrome
- Tic disorder or Tourette syndrome
- Rule out child abuse if significant scalp laceration, skull fracture, or intracerebral or subdural hemorrhage.
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