Head nodding

  • 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

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