The reference is most common with regard to a wedding or a company dinner. The bride/bridegroom and their parents will be on the top table. In a company dinner the chairman and senior directors will be on the top table - the most important people in that company.
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Alan.esI've never heard it said as 'head table'. It's always been the 'top table' at the many weddings and dinners I've attended in the UK.Generally, you're right, but see this example, which seems BrE: