Identifier |
166-24 |
Title |
Elliptical Nystagmus |
Creator |
Shirley H. Wray, MD, PhD, FRCP |
Affiliation |
(SHW) Professor of Neurology, Harvard Medical School; Director, Unit for Neurovisual Disorders, Massachusetts General Hospital, Boston, Massachusetts |
Subject |
Primary Position Elliptical Nystagmus; Multiple Sclerosis |
History |
The patient carries a diagnosis of multiple sclerosis. |
Disease/Diagnosis |
Multiple Sclerosis |
Clinical |
This is a rather unique case of primary position nystagmus where we can see the eyes moving elliptically. This patient with MS has the elliptical form of acquired pendular nystagmus. (APN) APN has horizontal, vertical and torsional components, although one component may predominate. If the horizontal and vertical oscillations are in phase, the trajectory of the nystagmus is oblique. If the horizontal and vertical osillary components are out of phase, the trajectory of the nystagmus is elliptical, as in this case. A special case is when horizontal and vertical components are equal but are 90 degrees phase shifted. The trajectory is then circular. Oscillopsia is a prominent symptom with APN, but is seldom a complaint with the congenital form. |
Presenting Symptom |
Oscillopsia |
Ocular Movements |
Primary Position Elliptical Nystagmus |
Neuroimaging |
See Ref #4 |
Etiology |
Table 10-6, p505 Etiology of Pendular Nystagmus, Ref #3 |
Date |
1982 |
References |
1) Averbuch-Heller L, Zivotofsky AZ, Das VE, DiScenna AO, Leigh RJ. Investigations of the pathogenesis of acquired pendular nystagmus. Brain. 1995 Apr;118 ( Pt 2):369-78. http://www.ncbi.nlm.nih.gov/pubmed/7735879 2) Barton JJ, Cox TA. Acquired pendular nystagmus in multiple sclerosis: clinical observations and the role of optic neuropathy. J Neurol Neurosurg Psychiatry. 1993 Mar;56(3):262-7. http://www.ncbi.nlm.nih.gov/pubmed/8459242 3) Leigh RJ, Zee DS. The Neurology of Eye Movements 4th Edition. Oxford University Press, New York 2006. 4) Lopez LI, Bronstein AM, Gresty MA, Du Boulay EP, Rudge P. Clinical and MRI correlates in 27 patients with acquired pendular nystagmus. Brain. 1996 Apr;119 ( Pt 2):465-72. http://www.ncbi.nlm.nih.gov/pubmed/8800942 |
Language |
eng |
Format |
video/mp4 |
Type |
Image/MovingImage |
Source |
16 mm film |
Relation is Part of |
923-1; 941-3 |
Collection |
Neuro-Ophthalmology Virtual Education Library: Shirley H. Wray Collection: https://novel.utah.edu/Wray/ |
Publisher |
North American Neuro-Ophthalmology Society |
Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
Rights Management |
Copyright 2002. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
ARK |
ark:/87278/s67t0kbg |
Setname |
ehsl_novel_shw |
ID |
188621 |
Reference URL |
https://collections.lib.utah.edu/ark:/87278/s67t0kbg |