Walsh & Hoyt: Ocular Motor Manifestations of Seizures

Eye and head movements are common manifestations of epileptic seizures, and the wide representation of oculomotor and vestibular control within the cerebral cortex leads to a number of possible ways that seizures can affect eye movements themselves and visual or vestibular perceptions. A variety of eye movements can occur with seizures, including horizontal or vertical gaze deviation, skew deviation, and spontaneous, retractory, periodic alternating or monocular nystagmus. Epileptic convergence nystagmus may occur with periodic lateralizing epileptiform discharges and with burst-suppression patterns. The seizure focus may arise from any lobe, although the lesions usually are more posterior. Epileptic nystagmus can occur with typical absence seizures and with infantile spasms.