Which form of nystagmus is typically accompanied by compensatory head nodding?

• A. Latent nystagmus
• B. Gaze-evoked nystagmus
• C. Spasmus nutans
• D. Convergence-retraction syndrome

Answer: (C)

Spasmus nutans presents in infancy with a distinctive triad: pendular nystagmus accompanied by rapid head nodding. The head nodding acts as a compensatory mechanism to stabilize the visual image and dampen the eye movement, helping the child maintain fixation despite the nystagmus. This pattern is typical in young children and most commonly resolves on its own by early childhood. Other forms of nystagmus—such as latent nystagmus, which appears mainly when one eye is covered; gaze-evoked nystagmus, which arises in eccentric gaze due to neural integrator issues; or convergence-retraction syndrome, a dorsal midbrain condition with different accompanying signs—do not characteristically include the same compensatory head nodding. The presence of head bobbing with pendular nystagmus in infancy is a classic cue pointing to spasmus nutans.