Spasmus Nutans on Ocular Examination



At first I thought it was Pendular But a closer look reveals them to be more shimmering and horizonto-Rotary. Then she says: I’ve had this since childhood and I used to tilt my head constantly to the left side and sometimes my head used to Bob up and down to get a better look



Spasmus nutans is an acquired form of nystagmus that occurs in children typically within the first 2 years of life. It presents as a clinical triad of 1) nystagmus 2) head bobbing 3) torticollis. Head bobbing and torticollis are mechanisms to improve vision.



Now her head bobbing has gone away but an occasional head tilt still persists along with the shimmering eye movements



Dr. Boby Varkey Maramattom @bobvarkey



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