Bobble-head Doll Syndrome Research Articles

Bobble—head doll syndrome and drop attacks in a child with a cystic choroid plexus papilloma of the third ventricle

The authors report an unusual case of a 2-year-old boy with a 3-month history of episodic rightward anterolateral head tilt and large-amplitude positional anteroposterior head bobbing reminiscent of bobble-head doll syndrome. This child experienced a sudden onset of drop attacks and then, within several hours, deep coma. The causative lesion was a contrast-enhancing, partially cystic third ventricular mass, which ultimately obstructed the aqueduct, producing profound obstructive hydrocephalus. An emergency ventriculostomy and endoscopic fenestration of the septum pellucidum was performed. Four days later, the tumor was completely resected by a transcallosal-transforaminal approach. The lesion was freely mobile within the third ventricle and contained a large cyst within its posterior pole; following drainage of the cyst, the lesion was easily delivered through the foramen of Monro. The histopathological diagnosis was choroid plexus papilloma. The child's neurological deficits, head tilt, and head bobbing resolved immediately after operation. To the best of the authors' knowledge, this represents the first well-documented report of bobble-head doll syndrome and drop attacks secondary to a choroid plexus papilloma. The highly mobile nature of the cystic lesion presumably led to its intermittent impaction within the foramen of Monro and/or proximal aqueduct; this produced the intermittent head tilt and bobble-head symptoms and, ultimately, resulted in acute obstruction of the aqueduct, causing the child's precipitous neurological decline.

Bobble-head doll syndrome associated with the III ventricular cyst. Three cases in children 7 years after CVP or CVA shunting.

Thirty-nine cases of the bobble-head doll syndrome have been operated upon and are described in the literature. The authors re-evaluate three cases of III ventricle cysts treated with cystoventriculoperitoneal (CVP) or cystoventriculoatrial (CVA) shunting 7 years ago. In the first case (a 4.5-year-old girl), the CVP shunt was removed after 16 months due to suppuration around the device after trauma of the scalp. Nevertheless, the communication between the ventricle and cyst continued and the bobbing never returned. In the second case (a 10-year-old girl), after 4.5 years a pseudocyst at the end of the peritoneal catheter was accidentally found. It was evacuated and, as in the third case (a 17-year-old boy) follow-up for 7 years showed excellent results from the clinical point of view and CT scans.

Bobble-head doll syndrome due to trapped fourth ventricle and aqueduct

The bobble-head doll syndrome has been associated with third ventriculomegaly due to cysts or aqueductal stenosis. A case is described in which the aqueduct and fourth ventricle are enlarged, but the third ventricle is not. The unifying pathogenesis for this and previous cases is pressure on the dorsomedial red nucleus.

Bobble-head doll syndrome: Review of the pathophysiology and CSF dynamics

The bobble-head doll syndrome is a rare movement disorder; fewer than 40 cases have been reported. It is usually associated with cystic abnormalities in the region of the anterior third ventricle. Various physiologic mechanisms have been proposed but none of them has been substantiated. We report a patient with this syndrome produced by a suprasellar arachnoid cyst. The CSF dynamics were investigated with CT cisternography. The phenomenon was apparently the result of intermittent obstruction at the foramina of Monro, a feature which has not previously been reported in this condition. The head movement served to partially relieve intraventricular obstruction, by both a posterior displacement of the cyst away from the foramina of Monro and a reduction in cyst size. This finding supports the concept that the bobble-head syndrome may be a “learned” behavior which lessens the symptomatology of hydrocephalus related to foramina of Monro obstruction.

Treatment of Bobble-Head Doll Syndrome by Transcallosal Cystectomy

Abstract A 9-year-old boy with bobble-head doll syndrome, precocious puberty, and progressive memory loss is described. His evaluation included computed tomographic scanning with metrizamide and air ventriculography. A cyst within the 3rd ventricle was excised subtotally by a transcallosal approach. Postoperatively, his head bobbing lessened and his memory improved.

Treatment of bobble-head doll syndrome by transcallosal cystectomy

Treatment of bobble-head doll syndrome by transcallosal cystectomy

Optic Atrophy in the Bobble-Head Doll Syndrome

Optic Atrophy in the Bobble-Head Doll Syndrome

Slow tremor and macrocephaly: Expanded version of the bobble-head doll syndrome

The clinical features of three children in whom a slow tremor involving the head, trunk, or limbs was associated with macrocephaly are presented. The findings were similar but not identical to those previously reported in four children with the bobble-head doll syndrome. These seven children have many of the signs and symptoms found in patients with surgically or spontaneously arrested hydrocephalus, including motor incoordination, behavior and psychologic deviations, and endocrine dysfunction. The tremor which can be voluntarily inhibited and which disappears following shunt surgery, is unique. The theoretical basis for the tremor is briefly discussed.

A neuroanatomical basis for the bobble-head doll syndrome.

✓ A case of the bobble-head doll syndrome in association with aqueductal stenosis is presented. The relationship between the dilated third ventricle and adjacent thalamic nuclei as well as the somatotopic motor pattern of the dorsomedial thalamic nucleus is discussed.

Head Bobbing Associated With Third Ventricular Cyst

THE name bobble-head doll syndrome was adopted by Benton et al 1 to describe two children with unique truncal tremor associated with a third ventricular cyst and hydrocephalus. These authors reviewed the literature and could find no reference to a similar syndrome. They commented, however, that personal communication uncovered similar cases of which no details were given. We have seen this unusual syndrome, characterized by to-and-fro nodding of the head and trunk, in a young child with a cyst that involved the walls of the third ventricle. Report of a Case This 21/2-year-old Negro boy was admitted to the hospital with chief complaints of poor development and a shaking motion of the head. The child had never been weaned. He did not sit up or develop at the normal age. At 6 or 8 months of age, he tried sitting up but would fall over. He attempted walking at

A Case of Bobble-head Doll Syndrome Associated with Psychopathic Behaviors.

A Case of Bobble-head Doll Syndrome Associated with Psychopathic Behaviors.

THE BOBBLE-HEAD DOLL SYNDROME: A "TIC" WITH A NEUROPATHOLOGIC BASIS

A third patient with the "bobble-head doll syndrome" was reported. This is a "tic-like" movement disorder described thus far only in children. Its chief features are a 2 to 3 per second up-and-down or to-and-fro bobbing of the head, sometimes also of the trunk, which could be inhibited voluntarily and disappeared in sleep. Each child had chronic, slowly-progressive hydrocephaly, including marked enlargement of the third ventricle. In the patient presented here this was due to aqueductal stenosis, probably acquired; in the two patients presented previously a large cyst was found in the region of the third ventricle. Because surgical relief of hydrocephaly resulted in disappearance, or at least marked reduction of the head-bobbing, recognition of this "tic" with a neuropathologic basis is of therapeutic importance.