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Epileptic nystagmus: A case report and systematic review

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Authors
Lee, Sun-Uk; Suh, Hong-Il; Choi, Jun Young; Huh, Kyun; Kim, Hyo-Jung; Kim, Ji-Soo
Issue Date
2014-08
Publisher
Elsevier
Citation
Epilepsy and Behavior Case Reports, Vol.2 pp. 156-160
Keywords
의약학SeizureNystagmusEpileptic nystagmusIctal nystagmus
Description
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
Abstract
Purpose: We aimed to define the characteristics of epileptic nystagmus and correlate those with other clinical findings in a large number of patients. Methods: We report a patient with epileptic nystagmus and additionally reviewed the reported clinical features of 36 more patients through a systematic literature search. We analyzed the characteristics of epileptic nystagmus and attempted correlations of those with alertness of the patients and epileptic foci on EEG. Results: All 33 patients with unilateral horizontal nystagmus showed nystagmus beating away from the side of ictal discharges. Epileptic nystagmus was preceded by gaze deviation in 21 patients, with contraversive in 19 and ipsiversive in 2. Seizures associated with epileptic nystagmus were mostly focal (25/29, 86.2%) with or without loss of awareness. Ictal discharges originated from the occipital (n = 16), parietal (n = 9), temporo-occipital (n = 6), frontal (n = 4), and temporal (n = 3) areas, and two patients had multiple epileptic foci. Seizures were usually symptomatic (24/37, 64.9%). The presence of preceding gaze deviation and midline crossing of the nystagmus did not correlate with the ictal onset zone or alertness of the patients. Recording of epileptic nystagmus was available only in 6 patients, and the epileptic nystagmus could be localized to the saccadic areas in two and to the smooth pursuit areas in another two. Two patients showed the features of epileptic nystagmus from both areas. Conclusion: Even though the localizing value of epileptic nystagmus seems limited in previous reports, the fast phase of epileptic nystagmus was almost always directed away from the epileptic focus that mostly arose from the posterior part of the cerebral hemisphere.
ISSN
2213-3232
Language
English
URI
https://hdl.handle.net/10371/94274
DOI
https://doi.org/10.1016/j.ebcr.2014.08.004
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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