Spasmus Nutans

    • Idiopathic low-amplitude, high-frequency pendular nystagmus
    • Amplitude in one eye is often so small that the nystagmus appears monocular
    • Appears between 6 and 36 months of age
    • Often accompanied by truncal ataxia, head titubation, head tilt
    • Cause is unknown
    • No treatment
    • Spontaneous resolution occurs after months to years
    • Fine horizontal oscillations often evident only in one eye
    • Truncal ataxia, head titubation (nodding), head tilt (torticollis) often present
    • No other ophthalmologic or neurologic abnormalities
    • No systemic abnormalities
    • MRI brain and other diagnostic tests are normal
    • Infantile motor nystagmus
    • Infantile sensory nystagmus
    • Acquired binocular pendular nystagmus
    • Ocular flutter/opsoclonus
    • Patient should undergo brain imaging, and probably lumbar puncture, which are warranted because the manifestations suggest rhombencephalitis
    • There is no effective treatment
    • Nystagmus and associated findings will disappear completely within 36 months and usually leave no residual damage
    • Trap: low-amplitude nystagmus typical of spasmus nutans has been detected in patients with anterior visual pathway gliomas or retinal dystrophies, so those entities must be kept in mind
    • Tip: electroretinography can be reliably performed in children under age 1 without the need for anesthesia

    Nystagmus

    Overview Video Nystagmus Overview Physiologic Nystagmus Infantile Motor Nystagmus Infantile Sensory Nystagmus Monocular Pendular Nystagmus of Childhood Spasmus Nutans Peripheral Vestibular Nystagmus Gaze-evoked Horizontal (Sidebeat) Nystagmus Upbeat Nystagmus Downbeat Nystagmus Acquired Binocular Pendular Nystagmus