Video 5.27 Elliptical acquired pendular nystagmus (APN) in multiple sclerosis (MS) from Neuro-Ophthalmology and Neuro-Otology Textbook
Creator
Daniel R. Gold, DO
Affiliation
(DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject
Pendular Nystagmus; Multiple Sclerosis
Description
𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-yo-woman with MS and bilateral optic nerve disease who presented with a year's long history of oscillopsia, which was related to elliptical pendular nystagmus. The appearance of elliptical nystagmus is the result of out of phase horizontal and vertical components. She had a variety of posterior fossa lesions on MRI, and there was mild improvement with gabapentin. Memantine is another treatment option, and sometimes using the two together is more effective than using either individually. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: This patient with a 10+ year history of MS and bilateral optic nerve disease presented oscillopsia for 1 year, due to elliptical APN which seen on exam. The appearance of elliptical nystagmus is the result of out of phase horizontal and vertical (pendular) components, and can be especially visually debilitating. She had a variety of posterior fossa lesions on MRI, and there was mild improvement with gabapentin. https://collections.lib.utah.edu/ark:/87278/s6qn9w2n
