Bobble-head doll syndrome (BHDS) is a rare pediatric movement disorder 
presenting with involuntary 2- to 3-Hz head movements. Common signs and symptoms 
also found on presentation include macrocephaly, ataxia, developmental delay, 
optic disc pallor or atrophy, hyperreflexia, tremor, obesity, endocrinopathy, 
visual disturbance or impairment, headache, and vomiting, among others. The 
syndrome is associated with suprasellar cysts, third ventricular cysts, or 
aqueductal obstruction, along with a few other less common conditions. The cause 
of involuntary head motions is not understood. Treatment is surgical. The 
authors present 2 cases of BHDS. The first is a 14-year-old boy with BHDS 
associated with aqueductal obstruction and triventricular hydrocephalus 
secondary to a tectal tumor. He was successfully treated by endoscopic third 
ventriculostomy, and all symptoms resolved immediately in the recovery room. 
This case is unusual in its late age of symptom onset, the primacy of lateral 
("no-no") involuntary head rotations, and the associated tectal tumor. The 
second case is a 7.5-year-old girl with BHDS associated with a suprasellar cyst. 
She was successfully treated with an endoscopic fenestration but preexisting 
endocrinopathy persisted, and the patient was diagnosed with autism spectrum 
disorder at age 12 years. This second case is more typical of BHDS. A 
comprehensive and up-to-date review of the literature of BHDS and video 
documentation of the phenomenon are presented.