A Rare Case of Spasmus Nutans in an Infant

We report a case of an otherwise healthy 23-month-old boy who presented with nystagmus, head shaking, andabnormal posture suggestive spasmus nutans. Neuro-ophthalmologic exam revealed bilateral, low-amplitude, high-frequency, horizontal, disconjugate nystagmus that was more prominent in one eye along shaking and tilt or face turn. The rest the systemic physical examination were normal. Magnetic resonance imaging brain did not disclose optic pathway glioma, which has been reported to cause nutans-like disease. Electroretinogram (ERG) also recommended rule out occult retinopathies. However, it done due unavailability appropriate corneal electrode for his age. Instead, close follow-up advised monitor spontaneous improvement resolution, until child comes age he can undergo ERG. This highlights management approach rationale patients presumed Recognition triad nutans allows quick diagnosis focused efficient investigation.