- Head nodding without accompanying nystagmus can occur as paroxysmal events in older infants and toddlers
- These head movements can be lateral (“no-no”), vertical (“yes-yes”), or oblique. The episodes may occur several times per day. The frequency (1–2 Hz) is slower than that of shuddering.
- The movements do not occur when the child is lying down, but can occur in the sitting or standing position. Older children describe an inability to suppress the movement.
- Some children may have a family history of essential tremor.
- Typically, development and neurologic outcomes are unaffected by this condition.
- Remission is spontaneous within months and treatment is not needed.
- The differential diagnosis includes: spasmus nutans, stereotypies and bobble-head syndrome due to third ventricle tumor.
Read classification of ” Paroxysmal Non Epileptic Events PNEE“