What is Bobblehead Syndrome?

“Bobblehead syndrome” is a rare movement disorder characterized by forward and backward head bobbing and side-to-side movements that occur at 2 to 3 Hz. These movements are absent during sleep and can be inhibited voluntarily, though they become stronger during activity. The movement disorder is a sign of progressive hydrocephaly, which is an enlargement of the third ventricle of the brain.

The symptoms of bobble-head syndrome usually start during childhood and last into adulthood. They are characterized by stereotyped head movements that have a 2 to 3 Hz frequency, and are exacerbated by excitement and stress. These movements tend to improve when the patient becomes more aware of their actions. BHDS is uncommon in children, with fewer than 60 cases reported in the medical literature. Symptoms can be subtle or accompanied by the presence of other conditions, such as tics.

The underlying cause of bobble-head doll syndrome is unknown. However, there are some possible theories that explain the phenomenon. One theory is that it stems from cystic abnormalities in the third ventricle, which can lead to hydrocephalus. While a third ventricle dilation is the most common cause of bobble-head syndrome, many patients do not develop this abnormality.

In one case, a 19-year-old woman reported involuntary head movements since her childhood. She was referred to several hospitals and was initially diagnosed as having a functional disorder. However, a detailed assessment revealed that she had a large supra-sellar arachnoid cyst that was causing her involuntary head movements. This is an unusual diagnosis for bobble-head syndrome, but the patient’s symptoms improved after an endoscopic third ventriculostomy with cyst fenestration.