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Spasmus nutans

Definition

Spasmus nutans is a disorder affecting infants and young children. It involves rapid, uncontrolled eye movements, head bobbing, and sometimes, holding the neck in an abnormal position.

Causes

Most cases of spasmus nutans begin between age 6 months and 1 year. It usually lasts about 2 years but can go on as long as 5 years.

The cause is unknown, although it may be associated with other medical conditions. A link with iron or vitamin D deficiency has been suggested. In very rare cases, symptoms similar to spasmus nutans may be due to certain types of brain tumors or other serious conditions.

Symptoms

Symptoms of spasmus nutans include:

• Small, quick, side-to-side eye movements called nystagmus (both eyes are involved, but each eye may move differently)
• Head nodding
• Head tilting

Exams and Tests

Your health care provider will perform a physical exam of your child. You may be asked about your child's symptoms.

Tests may include:

• CT scan of the head
• MRI scan of the head
• Electroretinography, a test that measures the electrical response of the retina (the back part of the eye)

Treatment

Spasmus nutans that isn't related to another medical problem, such as brain tumor, requires no treatment. If the symptoms are caused by another condition, your provider will recommend appropriate treatment.

Outlook (Prognosis)

Usually, this disorder goes away on its own within 1 to 2 years without treatment. Some children have residual eye symptoms that need follow-up care.

When to Contact a Medical Professional

Contact your child's provider if your child has rapid, movements of the eyes, or head nodding. Your provider will need to perform an exam to check for other possible causes for the symptoms.

References

Hertle RW, Hanna NN. Supranuclear eye movement disorders, acquired and neurologic nystagmus. In: Lyons CJ, Lambert SR, eds. Taylor and Hoyt's Pediatric Ophthalmology and Strabismus. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 91.

Mikati MA, Obeld MM. Conditions that mimic seizures. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 634.

Rucker JC, Lavin PJM. Neuro-ophthalmology: ocular motor system. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 18.

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