Spasmus nutans consists of a triad of symptoms including nystagmus, head nodding, and head tilt. The symptoms can wax and wane during the course of the day and, therefore, be confused with epileptic seizures. The onset of the symptoms is usually during the first few months of life. The etiology of this disorder is unknown, although the triad has been associated with mass lesions at the optic chiasm or third ventricle. A head MRI scan should be obtained in these infants. If no abnormality is revealed, no further work-up or treatment is required. The symptoms usually resolve by age 5 years.
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