Skip to main content

Advertisement

SpringerLink
Log in

Localizing forms of nystagmus: Symptoms, diagnosis, and treatment

  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Nystagmus is a rhythmic oscillation of the eyes that may be acquired or congenital. The symptoms of acquired nystagmus include blurred vision and oscillopsia. Most patients with congenital nystagmus do not have oscillopsia symptoms. Several forms of nystagmus have localizing value and any neuroimaging should be directed to the topographic localization suggested by the morphology of the nystagmus and any accompanying localizing signs. Several optical, medical, and surgical treatments have been used with some success in specific forms of nystagmus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Hadjikoutis S, Morgan JE, Wild JM, Smith PE: Ocular complications of neurological therapy. Eur J Neurol 2005, 12:499–507. A description of ocular complications, including nystagmus, for various types of neurologic treatment.

    Article  PubMed  CAS  Google Scholar 

  2. Serra A, Leigh RJ: Diagnostic value of nystagmus: spontaneous and induced ocular oscillations. J Neurol Neurosurg Psychiatry 2002; 73:615–8.

    Article  PubMed  CAS  Google Scholar 

  3. Kim JS: Internuclear ophthalmoplegia as an isolated or predominant symptom of brainstem infarction. Neurology 2004, 62:1491–1496. This is an interesting paper that emphasizes that brainstem infarction can present to the ophthalmologist or the primary care physician with double vision in isolation.

    PubMed  Google Scholar 

  4. Unsold R, Ostertag C: Nystagmus in suprasellar tumors: recent advances in diagnosis and therapy. Strabismus 2002, 10:173–177.

    Article  PubMed  Google Scholar 

  5. Choi KD, Jung DS, Park KP, et al.: Bowtie and upbeat nystagmus evolving into hemi-seesaw nystagmus in medial medullary infarction: possible anatomic mechanisms. Neurology 2004, 62:663–665. A report summarizing the possible anatomic mechanisms for unusual types of nystagmus.

    PubMed  Google Scholar 

  6. Frohman EM, Dewey RB, Frohman TC: An unusual variant of the dorsal midbrain syndrome in MS: clinical characteristics and pathophysiologic mechanisms. Mult Scler 2004, 10:322–325. A report of an unusual variant of monocular CRN in the right eye with divergence-retraction nystagmus in the left eye in a patient with multiple sclerosis.

    Article  PubMed  Google Scholar 

  7. Kumar S: Memantine: pharmacological properties and clinical uses. Neurol India 2004, 52:307–309.

    PubMed  Google Scholar 

  8. Tilikete C, Vighetto A, Trouillas P, Honnorat J: Anti-GAD antibodies and periodic alternating nystagmus. Arch Neurol 2005, 62:1300–1303. Anti-GAD antibodies might be useful in several different types of unexplained nystagmus.

    Article  PubMed  Google Scholar 

  9. Rambold H, Helmchen C: Spontaneous nystagmus in dorsolateral medullary infarction indicates vestibular semicircular canal imbalance. J Neurol Neurosurg Psychiatry 2005, 76:88–94. These authors proposed that vestibular imbalance caused by an ipsilesional lesion of the central semicircular canal pathways of the horizontal and anterior semicircular canal accounts for the nystagmus in lateral medulllary syndromes.

    Article  PubMed  CAS  Google Scholar 

  10. Helmchen C, Rambold H, Kempermann U, et al.: Localizing value of torsional nystagmus in small midbrain lesions. Neurology 2002, 59:1956–1964.

    PubMed  CAS  Google Scholar 

  11. Younge BR, Khabie N, Brey RH, Driscoll CL: Rotatory nystagmus synchronous with heartbeat: a treatable form of nystagmus. Trans Am Ophthalmol Soc 2003, 101:113–117. A novel and potentially treatable form of nystagmus.

    PubMed  Google Scholar 

  12. Tilikete C, Krolak-Salmon P, Truy E, Vighetto A: Pulsesynchronous eye oscillations revealing bone superior canal dehiscence. Ann Neurol 2004, 56:556–560. A novel and potentially treatable form of nystagmus.

    Article  PubMed  Google Scholar 

  13. Pierrot-Deseilligny C, Milea D: Vertical nystagmus: clinical facts and hypotheseS. Brain 2005;128:1237–1246. The authors review vertical nystagmus, including the anatomy and pathogenesis.

    Article  PubMed  CAS  Google Scholar 

  14. Glasauer S, Kalla R, Buttner U, et al.: 4-aminopyridine restores visual ocular motor function in upbeat nystagmus. J Neurol Neurosurg Psychiatry 2005, 76:451–453. This paper describes the use of 4-aminopyridine treatment in upbeat nystagmus.

    Article  PubMed  CAS  Google Scholar 

  15. Alkawi A, Kattah JC, Wyman K: Downbeat nystagmus as a result of lamotrigine toxicity. Epilepsy Res 2005, 63:85–88. This paper reports on an unusual complication of lamotrigine treatment.

    Article  PubMed  CAS  Google Scholar 

  16. Strupp M, Schuler O, Krafczyk S, et al.: Treatment of downbeat nystagmus with 3,4-diaminopyridine: a placebocontrolled study. Neurology 2003, 61:165–170. This study demonstrated that single dose of 3,4 diaminopyridine can significantly improve downbeat nystagmus.

    Article  PubMed  CAS  Google Scholar 

  17. Antonini G, Nemni R, Giubilei F, et al.: Autoantibodies to glutamic acid decarboxylase in downbeat nystagmus. J Neurol Neurosurg Psychiatry 2003, 74:998–999.

    Article  PubMed  CAS  Google Scholar 

  18. Ances BM, Dalmau JO, Tsai J, et al.: Downbeating nystagmus and muscle spasms in a patient with glutamicacid decarboxylase antibodies. Am J Ophthalmol 2005, 140:142–144.

    Article  PubMed  Google Scholar 

  19. Straube A, Leigh RJ, Bronstein A, et al.: EFNS task force-therapy of nystagmus and oscillopsia. Eur J Neurol 2004, 11:83–89. This is a nice summary of the treatments that are available for nystagmus. All of the available recommendations for treatment, however, are Class C recommendations.

    Article  PubMed  CAS  Google Scholar 

  20. Lee AG, Brazis PW: Clinical Pathways in Neuro-ophthalmology, edn 2. New York: Thieme; 2002.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, The H. Stanley Thompson Neuro-ophthalmology Clinic, 200 Hawkins Drive, 52242, Iowa City, IA, USA

    Andrew G. Lee MD

Authors
  1. Andrew G. Lee MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul W. Brazis MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew G. Lee MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, A.G., Brazis, P.W. Localizing forms of nystagmus: Symptoms, diagnosis, and treatment. Curr Neurol Neurosci Rep 6, 414–420 (2006). https://doi.org/10.1007/s11910-996-0022-y

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11910-996-0022-y

Keywords

Search

Navigation