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Spasmus Nutans


Presentation

  • CONCLUSIONS: A substantial proportion of patients presenting with SN-like nystagmus have important underlying ocular, intracranial, or systemic abnormalities that may require evaluation and management.[ncbi.nlm.nih.gov]
  • PURPOSE: To investigate the nystagmus of twin brothers presenting with spasmus nutans later diagnosed as Bardet-Biedl syndrome. METHODS: The twins presented at the age of 14 months with a presumed diagnosis of spasmus nutans.[ncbi.nlm.nih.gov]
  • The clinical features of head nodding, nystagmus and head tilt are diagnostic although variability in their presentation is not uncommon. Computerized tomography of the head is recommended to rule out possible accompanying intracranial gliomas.[ncbi.nlm.nih.gov]
  • An eight-month-old child who presented with signs of spasmus nutans subsequently developed obstructive hydrocephalus, bilateral optic atrophy, and loss of vision due to a juvenile pilocytic astrocytoma involving the optic nerves, chiasm, and anterior[ncbi.nlm.nih.gov]
  • Abstract The purpose of the present study was to determine whether that which clinically appeared to be spasmus nutans could actually represent retinal sensory deficits diagnosable by electroretinography.[ncbi.nlm.nih.gov]
Pallor
  • Likewise, afferent pupillary defects and even mild optic disc pallor can be missed, especially in a non-cooperative child.[healio.com]
  • Other significant findings on complete ophthalmologic examination included optic disc pallor in 6 patients (27%); the pallor was bilateral in 5. Optic nerve hypoplasia was bilateral in 2 patients (9%) and was unilateral in 1 (4%).[journals.lww.com]
  • Warning signs to look for that might warrant a more hasty referral for brain MRI would be any evidence of optic nerve dysfunction such as optic disc pallor or relative afferent pupillary defect.[eyewiki.aao.org]
Sepsis
  • During the neonatal period, he was admitted to our hospital with a diagnosis of sepsis secondary to pneumonia. At that time, he was found to oscillate his head. The movement was found to be associated with horizontal oscillations of the eyes.[jamanetwork.com]
Failure to Thrive
  • One child had nystagmus and head nodding with normal fundi, but persistent failure to thrive that suggested a hypothalamic lesion from the onset.[ncbi.nlm.nih.gov]
Nystagmus
  • Ocular motility recordings revealed an unusual latent/manifest latent nystagmus, pendular nystagmus with characteristics of an acquired nystagmus, and uniocular saccades.[ncbi.nlm.nih.gov]
  • When the cyst was shunted the nystagmus lessened. Recent studies suggest that the head nodding and anomalous head position are adaptive mechanisms that compensate for the nystagmus and not pathological in themselves.[ncbi.nlm.nih.gov]
  • We undertook this study to determine the frequency of ocular, intracranial, and systemic conditions in patients with nystagmus having characteristics of SN.[ncbi.nlm.nih.gov]
  • However, subclinical nystagmus persists until at least 5 to 12 years of age.[ncbi.nlm.nih.gov]
  • PURPOSE: Spasmus nutans is a condition that includes asymmetric nystagmus and occurs during the amblyogenic period.[ncbi.nlm.nih.gov]
Nystagmus
  • Ocular motility recordings revealed an unusual latent/manifest latent nystagmus, pendular nystagmus with characteristics of an acquired nystagmus, and uniocular saccades.[ncbi.nlm.nih.gov]
  • When the cyst was shunted the nystagmus lessened. Recent studies suggest that the head nodding and anomalous head position are adaptive mechanisms that compensate for the nystagmus and not pathological in themselves.[ncbi.nlm.nih.gov]
  • We undertook this study to determine the frequency of ocular, intracranial, and systemic conditions in patients with nystagmus having characteristics of SN.[ncbi.nlm.nih.gov]
  • However, subclinical nystagmus persists until at least 5 to 12 years of age.[ncbi.nlm.nih.gov]
  • PURPOSE: Spasmus nutans is a condition that includes asymmetric nystagmus and occurs during the amblyogenic period.[ncbi.nlm.nih.gov]
Pendular Nystagmus
  • We used ocular motility recordings to identify the characteristics of a rare combination of conjugate, horizontal jerk, and pendular nystagmus in a 9-year-old boy.[ncbi.nlm.nih.gov]
  • All patients had fine, intermittent asymmetric, pendular nystagmus on eye movement recordings. CONCLUSIONS: Good visual acuity can be expected in patients with spasmus nutans; one third have normal stereo acuity.[ncbi.nlm.nih.gov]
  • Rhythmic head movements and fine, intermittent, asymmetric, disconjugate, high-frequency, out-of-phase pendular nystagmus were recorded. Eye and head movement recordings of patients with congenital stationary night blindness can mimic spasmus nutans.[ncbi.nlm.nih.gov]
  • The dissociated, pendular nystagmus consists of high-frequency oscillations that may be disconjugate, conjugate, or purely uniocular.[ncbi.nlm.nih.gov]
  • Definition Spasmus nutans is a specific type of pendular nystagmus of infancy accompanied by head bobbing and occasionally by abnormal position of the neck.[health.am]
Involuntary Movements
  • It is not clear whether head nodding is a compensatory mechanism to control the nystagmus or an involuntary movement of pathologic origin.[ncbi.nlm.nih.gov]
  • Overview Quick Reference A combination of symptoms including a slow nodding movement of the head, nystagmus (involuntary movements of the eyes), and spasm of the neck muscles. It affects infants and it normally disappears within a year or two.[oxfordreference.com]
  • When to Contact a Medical Professional Call for an appointment with your health care provider if your child has rapid involuntary movements of the eyes or head nodding.[coordinatedhealth.com]
  • Calling your health care provider Call for an appointment with your health care provider if your child has rapid involuntary movements of the eyes or head nodding.[mostellarmedical.org]
Vertigo
  • There were no associated symptoms of gait disturbance or vertigo or hearing deficit. However. parents admitted that his scholastic performance was poor due to illegible handwriting.[docksci.com]
  • There were no associated symptoms of gait disturbance or vertigo or hearing deficit. However, parents admitted that his scholastic performance was poor due to illegible handwriting.[ncbi.nlm.nih.gov]
  • Lesions of the peripheral part of vestibular system (labyrinth) are accompanied by ataxia, vertigo and other signs of disturbances of the vegetative system.[intechopen.com]

Workup

  • Diagnosis: Laboratory investigation usually is not required for spasmus nutans.Exceptions include workup for metabolic or infectious etiology in congenital cataracts, serology in suspected toxoplasmosis, toxicology in optic atrophy, endocrine assay for[medigoo.com]
  • It is necessary for this kind of nystagmus to perform a complete neurological and endocrinological workup.[intechopen.com]

Treatment

  • Twelve of 18 patients required spectacles for improvement in visual acuity and for treatment of amblyopia.[ncbi.nlm.nih.gov]
  • […] tumor, requires no treatment.[pennstatehershey.adam.com]
  • Tests may include: CT scan of the head MRI scan of the head Treatment Return to top The benign form of spasmus nutans requires no treatment. Other conditions causing spasmus nutans must be treated individually.[rachel.education.gov.ck]

Prognosis

  • Spasmus nutans carries an excellent prognosis with 20/50 vision or better in most. A higher incidence of strabismus and amblyopia is associated in followed cases compared to controls.[shmabstracts.com]
  • Fortunately, for patients with the classic findings of spasmus nutans and a negative MRI, the prognosis is very good.[mattweedmd.com]
  • The purpose of our study was to record and characterize the long-term prognosis of children diagnosed with spasmus nutans. Methods : All patients under the age of 21 years with a diagnosis of spasmus nutans were included.[tandfonline.com]
  • Outlook (Prognosis) Usually, this disorder goes away on its own without treatment. Possible Complications There are usually no complications.[coordinatedhealth.com]
  • 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) Outlook (Prognosis) Usually, this disorder goes away on its own without treatment.[account.allinahealth.org]

Etiology

  • A better designation would be acquired nystagmus of infancy, which would not imply a benign etiology.[ncbi.nlm.nih.gov]
  • Atypical spasmus nutans is discussed and clinicians are alerted to a spectrum of possible etiologies.[ncbi.nlm.nih.gov]
  • etiology; Retrospective Studies; Spasms, Infantile, etiology; Torticollis, etiology; Visual Acuity, physiology Abstract BACKGROUND: There is uncertainty as to whether spasmus nutans (SN) is an isolated idiopathic entity or whether there are underlying[collections.lib.utah.edu]
  • A better designation would be acquired nystagmus of infancy, which would not imply a benign etiology. 1986 S. Karger AG, Basel Article / Publication Details First-Page Preview[karger.com]

Epidemiology

  • Summary Epidemiology The prevalence of SN is unknown.[orpha.net]
  • Epidemiology The precise incidence and prevalence of spasmus nutans are unknown, but it is considered rare. Correlation of demographic and socioeconomic factors has been reviewed since the early 1900s.[aao.org]
Sex distribution
Age distribution

Pathophysiology

  • Accurate simultaneous recordings of eye and head movements are required to understand the pathophysiological significance of these head oscillations.[ncbi.nlm.nih.gov]
  • The pathophysiologic role of cerebellar vermian hypoplasia in the generation of spasmus nutans remains unclear.[jamanetwork.com]
  • […] years, and is generally quoted as 6-12 months of age. 6 Though initially thought to resolve between 3 and 6 years of age, 7 more recent evidence from long-term follow up suggests there may be a persistence of subclinical nystagmus up to age 12 years. 8 Pathophysiology[aao.org]

Prevention

  • Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. ‎[books.google.ro]
  • Prevention Not applicable. Last revised: December 8, 2012 by Armen E. Martirosyan, M.D. Medical Encyclopedia All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care.[health.am]
  • Prevention References Olitsky SE, Hug D, Smith LP. Disorders of eye movement and alignment. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 622.[mostellarmedical.org]
  • By SHIVANI VORA Photo Credit Christopher Lee for The New York Times Making Playgrounds a Little More Dangerous “I came to the counterintuitive conclusion that engaging in risk is actually very important in preventing injuries,” a researcher says.[nytimes.com]
  • Moreover, the majority of gliomas in young children appear to involve multiple loci along the optic pathway; it is a matter of some debate whether excising an orbital glioma prevents future growth of intracranial glioma. 4.[healio.com]

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