Elliptical Nystagmus

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Identifier 166-24
Title Elliptical Nystagmus
Ocular Movements Primary Position Elliptical Nystagmus
Creator Shirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General Hospital
Contributor Primary Shirley H. Wray, MD, PhD, FRCP, Professor of Neurology, Harvard Medical School; Director, Unit for Neurovisual Disorders, Massachusetts General Hospital
Subject Primary Position Elliptical Nystagmus; Multiple Sclerosis
Presenting Symptom Oscillopsia
History The patient carries a diagnosis of 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.
Neuroimaging See Ref #4
Etiology Table 10-6, p505 Etiology of Pendular Nystagmus, Ref #3
Disease/Diagnosis Multiple Sclerosis
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
Relation is Part of 923-1; 941-3
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 1982
Type Image/MovingImage
Format video/mp4
Source 16 mm film
Rights Management Copyright 2002. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E, SLC, UT 84112-5890
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Language eng
ARK ark:/87278/s67t0kbg
Setname ehsl_novel_shw
Date Created 2008-04-16
Date Modified 2021-05-06
ID 188621
Reference URL https://collections.lib.utah.edu/ark:/87278/s67t0kbg