Am Orthopt J  49: 191-193  (1999).

Development of Spasmus Nutans After Initial Diagnosis of Infantile Esotropia

Katie M. Rose, C.O.
Susan A. Havertape, D.B.O., C.O.
Oscar A. Cruz, M.D.

Spasmus nutans is an acquired condition consisting of three clinical characteristics: head bobbing, asymmetric nystagmus, and torticollis. The head bobbing generally is manifested as an anteroposterior type nod along with an unpredictable side-to-side shaking of the head. This head bobbing has been found to be a compensatory movement to control the associated nystagmus. The nystagmus is usually fine, rapid, and disconjugate (often described as looking like an ocular shiver). It is commonly asymmetric and can be monocular in some patients. The torticollis varies from patient to patient but often involves both a head tilt and face turn.

Spasmus nutans usually presents within the first year of life and generally resolves within 1-2 years from the time of onset, although cases have been reported to take longer to resolve.

A patient is presented in whom the strabismus and spasmus nutans were entirely distinct conditions. The onset of spasmus nutans occurred during the course of follow-up for infantile esotropia, a situation which has not previously been reported in the literature. These findings suggest the development of strabismus in these patients may be independent of the onset of the spasmus nutans.

© 1999 The Board of Regents of the University of Wisconsin System