| Identifier |
936-1 |
| Title |
Benign Neonatal Ocular Flutter |
| Creator |
Shirley H. Wray, MD, PhD, FRCP |
| Contributors |
Steve Smith, Videographer |
| Affiliation |
(SHW) Professor of Neurology, Harvard Medical School; Director, Unit for Neurovisual Disorders, Massachusetts General Hospital, Boston, Massachusetts |
| Subject |
Benign Neonatal Ocular Flutter |
| History |
Shortly after birth, this baby was noted to have "jiggling eyes" by his mother. He was in good general health and neurologically intact. Cogan and I saw the baby and Cogan made the diagnosis of neonatal ocular flutter. In 1954 Cogan first used the term "ocular flutter" to describe a rare disorder of horizontal eye movements characterized by rapid bursts of synchronous back-to-back horizontal oscillatory movements usually seen in the primary position of gaze. Since then, there have been over 50 reports, usually single cases or small series, linking the phenomenon to a wide variety of brainstem and cerebellar conditions, e.g. post enteroviral infection, cerebral malaria, cyclosporine treatment and meningitis, but perhaps most frequently associated with parainfectious states or, with opsoclonus, as a paraneoplastic manifestation of occult malignancy. Benign neonatal ocular flutter should only be diagnosed when all other potential etiologies have been ruled out by appropriate investigations. |
| Disease/Diagnosis |
Benign Neonatal Ocular Flutter |
| Clinical |
This baby has benign neonatal ocular flutter. Watch this baby's eyes carefully for very short bursts of very fast conjugate horizontal back-to-back saccades without an intersaccadic interval. This tape is an excellent example of a case of benign neonatal ocular flutter. At this time, bursts of flutter were less frequent and shorter in duration than on his initial visit, three weeks previous to this recording. Ocular flutter resolved completely over the next six weeks. Idiopathic opsoclonus can however occur as a transient phenomenon in an otherwise normal infant. |
| Presenting Symptom |
Jiggling Eyes |
| Ocular Movements |
Ocular Flutter |
| Date |
1994 |
| References |
1. Ashe J, Hain TC, Zee DS, Schatz NJ. Microsaccadic flutter. Brain 1991;114:461-472. http://www.ncbi.nlm.nih.gov/pubmed/2004251 2. Cogan DG. Ocular dysmetria: flutter like oscillations of the eyes and opsoclonus. Arch Ophthalmol 1954;51:318-335. http://www.ncbi.nlm.nih.gov/pubmed/13123617 3. Dyken P, Kolar O. Dancing eye dancing feet: Infantile polymyoclonia. Brain 1968; 91:305-320. http://www.ncbi.nlm.nih.gov/pubmed/5721932 4. Hankey GJ, Sadka M. Ocular flutter postural body tremulousness and CSF pleocytosis: a rare postinfectious syndrome. J Neurol Neurosurg Psychiatry 1987;50:1235-1236. http://www.ncbi.nlm.nih.gov/pubmed/3668576 5. Hoyt CS, Mousel DK, Weber AA. Transient supranuclear disorders of gaze in healthy neonates. Am J Ophthalmol 1980;89:708-711. http://www.ncbi.nlm.nih.gov/pubmed/7377270 6. Hoyt CS, Gelbart SS. Vertical mystagmus in infants with congenital ocular abnormalities. Ophthalmic Pediatr Genet 1984;4:155-162. http://www.ncbi.nlm.nih.gov/pubmed/6443616 7. Kinsbourne M. Myoclonic encephalopathy of infants. J Neurol Neurosurg Psychiatry 1962;25:2712-276. http://www.ncbi.nlm.nih.gov/pubmed/21610907 8. Kuban KC, Ephros MA, Freeman RL, Laffell LB, Bresnan MJ. Syndrome of opsoclonus-myoclonus caused by Coxsackie B3 infection. Ann Neurol 1983;13:69-71. http://www.ncbi.nlm.nih.gov/pubmed/6299176 9. Leigh RJ, Zee DS. Diagnosis of Nystagmus and Saccadic Intrusion. Chp 10:475-558. In: The Neurology of Eye Movements, Fourth Edition. Oxford University Press, NY. 2006. 10. Orzechowski K, Walichiewicz T. Przypadek operowanej torbieli srodpajeczy mozdika (operated cyst of the cerebellum) Licowski Tygodnik Lekurski 1913;18:219-227. 11. Pranzatelli MR, Tate ED, Travelstead AL, Longee D. Immunologic and clinical responses to rituximab in a child with opsoclonus-myoclonus syndrome. Pediatrics 2005;115:115-119. http://www.ncbi.nlm.nih.gov/pubmed/15601813 12. Shawkat FS, Harris CM, Wilson J, Taylor DSI. Eye movements in children with opsoclonus. Neuropaediatrics 1993;24:218-223. http://www.ncbi.nlm.nih.gov/pubmed/8232781 13. Wiest G, Safoschnik G, Schnaberth G, Mueller C. Ocular flutter and truncal ataxia may be associated with enterovirus infection. J Neurology 1997, 244:288-292. http://www.ncbi.nlm.nih.gov/pubmed/9178152 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Source |
3/4" Umatic master videotape |
| Relation is Part of |
166-3, 166-4, 166-6, 936-8 |
| 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/s63r3qfp |
| Setname |
ehsl_novel_shw |
| ID |
188506 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s63r3qfp |
