Recognizing the Spasms: What to Look For

Recognizing infantile spasms can be difficult because they rarely look like the “shaking” seizures most people imagine. Because these movements are subtle and the condition is rare, it is very common for them to be initially misidentified as normal infant behaviors or digestive issues ^[1][2].

What the Spasms Look Like

Infantile spasms are highly variable, meaning they can look different from one baby to the next ^[3]. However, they often follow a specific pattern:

• The “Jackknife” Motion: This is the classic presentation where the baby suddenly bends forward at the waist, their head drops, and their arms fling out or up ^[3].
• Subtle Head Drops: Sometimes the only sign is a quick, repetitive nodding of the head.
• Extensor Spasms: Instead of bending forward, the baby may suddenly stiffen and arch their back, flinging their arms and legs outward.
• Eye Movements: You may notice the eyes rolling upward or deviating to the side just before or during a spasm ^[4][5].
• Asymmetry: If the movement seems to affect one side of the body more than the other, tell your doctor; this can sometimes point to a specific cause in the brain ^[6].

The “Cluster” Pattern

The most defining feature of these spasms is that they occur in clusters. A single spasm lasts only one or two seconds, but it is typically followed by another a few seconds later. These clusters can last for several minutes and most frequently occur during transitions between sleep and wakefulness (just after waking up or as the baby is drifting off to sleep) ^[7].

Why Misdiagnosis Happens

It is common for parents to be told their child has colic, reflux, or an exaggerated Moro reflex (the natural “startle” reflex) ^[1]. One specific condition, Sandifer Syndrome, involves unusual posturing caused by severe acid reflux and is frequently confused with spasms ^[8][9].

The key difference is often the “rhythm” of the movement. While a startle or a reflux cramp might happen once, infantile spasms almost always repeat in that steady, clustered cadence.

The Power of Your Smartphone

The single most important tool you have for a fast diagnosis is your phone. Because spasms may not happen while you are actually in the doctor’s office, showing a video is vital.

Research shows that using smartphone video to document these movements leads to:

• Faster Diagnosis: Doctors can recognize the “semiology” (the physical appearance) of the spasm immediately ^[10].
• Reduced “Lead Time”: The time between the first spasm and the start of treatment is significantly shortened ^[10].
• Better Outcomes: Faster treatment is directly linked to higher rates of stopping the spasms and better long-term developmental results ^[10][11].

If you suspect your child is having spasms, do not wait. Capture a video of a full cluster (especially during waking) and insist on an urgent evaluation by a pediatric neurologist.

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