Infant Head Jerking: Should I worry?

Q)Dear Dr. Gwenn:

Our 4.5 month old baby has recently started jerking his head from side to side (as if exercising the “no” movement, involuntarily). This phenomenon occurs mostly when he seems tired, but is not limited to this situation. I am quite worried, since the phenomenon appears both “wild” and involuntary.

Many thanks in advance.


A) Dear Odelia:

The situation you described is very common – young infants do on occasion have odd movements that can be very alarming to parents. And, falling asleep does seem to be a common time for these movements to occur.  Your infant may very well have a very benign head nodding condition called “spasmus nutans” which is head nodding, head titling and eye twitches called nystagmus where the eyes flicker side to side. While it is bothersome to parents, it is not dangerous and self-limited.  So, more times than not, it goes away with in a few months as mysteriously as it began.

However, this can’t be diagnosed without a more thorough examination and evaluation and would be what is called a “diagnosis of exclusion”, meaning this would be diagnosed after other neurological issues were ruled out.  At the very least, your pediatrician should examine your infant and perhaps even witness one of these episodes. A video of the episode would be a great diagnostic tool for this purpose. Depending on what your pediatrician thinks, a pediatric neurologist would be the best “expert” to help you really understand what these head jerkings are about – if anything. At the end of the day, these may just be odd movements but there is no way to know for sure without digging a bit deeper.


Dr. Gwenn