Bobble Head Doll Syndrome Revealing a Suprasellar Arachnoid Cyst : Case Report

Abstract

Introduction Bobble head doll syndrome (BHDS) is a rare neurological syndrome that appears in childhood. It is characterized by abnormal movements of the head, most commonly in an up-and-down motion ("yes yes") and rarely in the horizontal plane ("no no"). We report a case of BHDS revealing a large suprasellar arachnoid cyst. Observation A 6-year-old child was brought by his parents to a neurology consultation for abnormal head movements, which most frequently occurred in an upward and downward direction, but disappeared during sleep. These abnormal movements had been progressively worsening over the course of approximately one year. Clinical examination revealed a decrease in visual acuity in both eyes, with papillary hyperemia on fundoscopy and discreet ataxia in walking. Magnetic resonance imaging (MRI) revealed a compressive suprasellar arachnoid cyst with passive biventricular hydrocephalus. Surgical treatment with neuro-endoscopy led to a remarkable regression of abnormal head movements and ataxia in the immediate postoperative period, with complete disappearance in the long term. Conclusion Bobble head doll syndrome is a potentially "curable" entity, and diagnosis is provided by cerebral MRI.