Abstract • Spasmus nutans occurs in early childhood and consists of a triad of symptoms as follows: small-amplitude, rapid, horizontal nystagmus in one or both eyes asymmetrically; head nodding; and anomalous head position. Once thought to be a benign clinical entity, there are an increasing number of reports linking spasmus nutans to optic nerve and chiasmal gliomas. We describe 14 patients with spasmus nutans, none of whom were found to have a tumor with computed tomographic scanning. One patient, however, had an arachnoid cyst and an empty sella and another patient had a porencephalic cyst. The diagnosis of spasmus nutans, its implications, and its management are discussed. References 1. Kelly TW: Optic glioma presenting as spasmus nutans . Pediatrics 1970;45:295-296. 2. Donin JF: Acquired monocular nystagmus in children . Can J Ophthalmol 1967;2:212-215. 3. Antony JH, Ouvrier RA, Wise G: Spasmus nutans: A mistaken identity . Arch Neurol 1980; 37:373-375.Crossref 4. Koenig SB, Naidich TP, Zaparackas Z: Optic glioma masquerading as spasmus nutans . J Pediatr Ophthalmol Strabismus 1982;19:20-24. 5. Farmer J, Hoyt CS: Monocular nystagmus in infancy and early childhood . Am J Ophthalmol 1984;98:504-509.Crossref 6. Albright AL, Aclabassi RJ, Slamovits TL, et al: Spasmus nutans associated with optic gliomas in infants . J Pediatr 1984;105:778-780.Crossref 7. Lavery MA, O'Neill JF, Chu FC, et al: Acquired nystagmus in early childhood: A presenting sign of intracranial tumor . Ophthalmology 1984;91:425-435.Crossref 8. Cogan DG: Neurology of the Ocular Muscles . Springfield, Ill, Charles C Thomas Publishers, 1956, p 192. 9. Norton EWD, Cogan DG: Spasmus nutans: A clinical study of 20 cases followed two years or more since onset . Arch Ophthalmol 1954;52:442-446.Crossref 10. Osterberg G: On spasmus nutans . Acta Ophthalmol 1937;15:457-467.Crossref 11. Hoefnagel D, Biery B: Spasmus nutans . Dev Med Child Neurol 1968;10:32-35.Crossref 12. Gresty M, Leech J, Sanders M, et al: A study of head and eye movement in spasmus nutans . Br J Ophthalmol 1976;60:652-654.Crossref 13. Gresty MA, Halmagyi M: Abnormal head movements . J Neurol Neurosurg Psychiatry 1979;42:705-714.Crossref 14. Lloyd L: Gliomas of the optic nerve and chiasm in childhood . Trans Am Ophthalmol Soc 1973;71:488-535. 15. Miller NR, Iliff WJ, Green WR: Evaluation and management of gliomas of the anterior visual pathways . Brain 1974;97:743-754.Crossref 16. DeSousa AL, Kalsbeck JE, Mealey J Jr, et al: Optic chiasmatic glioma in children . Am J Ophthalmol 1979;87:376-381. 17. Chutorian AM, Schwartz JF, Evans RA, et al: Optic gliomas in children . Neurology 1964; 14:83-95.Crossref 18. Myles ST, Murphy SB: Gliomas of the optic nerve and chiasm . Can J Ophthalmol 1973;8:508-514. 19. Gabriel RS: Malformations of the central nervous system , in Menkes JH: Textbook of Child Neurology . Philadelphia, Lea & Febiger, 1980, p 188. 20. Adams RD, Victor M: Principles of Neurology . New York, McGraw-Hill International Book Co, 1981, pp 457, 466. 21. Kattah JC, Cohan SL, Cahill W, et al: Monocular rotatory nystagmus . J Clin Neuro Ophthalmol 1983;3:49-51.Crossref 22. Hoyt CS, Aicardi E: Acquired monocular nystagmus in monozygous twins . J Pediatr Ophthalmol Strabismus 1979;16:115-118. 23. Jayalakshmi P, Scott TFS, Tucker SH, et al: Infantile nystagmus: A prospective study of spasmus nutans, congenital nystagmus, and unclassified nystagmus of infancy . J Pediatr 1970;77:177-187.Crossref
Archives of Ophthalmology – American Medical Association
Published: Oct 1, 1986
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