Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Call emergency services if a child is difficult to wake, has severe breathing difficulty, has ongoing seizure activity, or develops sudden weakness or loss of consciousness.
These are not expected features of spasmus nutans.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Contact the child’s healthcare team sooner than planned if the movements are becoming much more frequent, vision seems worse, one eye is no longer tracking objects, or the child develops a new eye turn.
Seek urgent medical assessment for:
A white or unusual-looking pupil
Sudden loss or marked worsening of vision
Repeated vomiting with unusual eye movements
New weakness, poor balance, or difficulty walking
Loss of developmental skills
A severe or persistent headache in a child able to describe it
A new seizure or episodes of reduced awareness
3
Does any of this apply?
Book an appointment
Arrange a prompt, non-emergency appointment if you notice new repetitive eye movements, head nodding, or a persistent head tilt in a baby or young child.
A pediatric eye examination is appropriate even if the child otherwise seems well.
Every sign above is quoted from the sofidex article on Spasmus nutans. If you are not sure, err upward — it is always reasonable to be checked.