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2.1
Autosomal Dominant Congenital Nystagmus Type 4
NYS4

Presentation

If a child’s presentation does not precisely fulfill the criteria for congenital motor nystagmus, neuroradiologic testing is necessary. Spasmus nutans. Spasmus nutans is acquired, typically presenting between the ages of 3 and 15 months. [aao.org]

Latent Nystagmus Horizontal jerk nystagmus presents when the light stimulus is reduced to either eye (eg by occluding). In latent, no observable movement is present on uncovering and full BSV is restored. [slideshare.net]

However, pendular and triangular waveforms may also be present. The nystagmus may rarely be vertical. [malacards.org]

The signs and symptoms of neurological disease are elusive by their very nature, presenting a confounding diagnostic challenge. [books.google.ro]

Skin

  • Normal Hair

    The eyes are structurally normal and electrophysiologic studies (e.g., visual evoked potential, electroretinogram) are normal. [ncbi.nlm.nih.gov]

Neurologic

  • Upbeat Nystagmus

    Neurology, 60,2003, 344 Central nystagmus (downbeat, upbeat nystagmus, horizontal, torsional) Upbeat nystagmus (UBN). [tchain.com]

    Motor Imbalance Congential Spasmus Nutans Latent nystagmus Ataxic nystagmus Downbeat nystagmus Upbeat nystagmus Convergence retraction nystagmus See-Saw nystagmus Periodic alternating nystagmus 7. [slideshare.net]

    Cross-eyed Squint Squint eyes [ more ] 0000486 Upbeat nystagmus 0011477 Showing of 7 | Last updated: 7/1/2019 If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. [rarediseases.info.nih.gov]

Workup

Recommended lab workup includes TORCH titers, VDRL, serum calcium and phosphorus levels and urine for reducing substance. Additional systemic workup should be done in coordination with the pediatrician. [eyewiki.aao.org]

It is accepted as neurologically benign, however, in cases with associated systemic and neurological problems and in cases that is diagnosed after 6 months neuroradiological evaluation and systemic workup are required. [omicsonline.org]

Jugular Venous Pressure

  • Absent A-Waves

    b-waves in CSNB1 & reduced but measurable b-waves in CSNB2 (absent b-wave may be referred to as a "negative ERG." [ncbi.nlm.nih.gov]

Other ECG Findings

  • Abnormal ECG

    Cardiac abnormalities include ventricular hypertrophy and systolic ejection murmurs. Exertional dyspnea is frequent, with angina less frequent. 65% have an abnormal ECG with inverted T-waves and signs of ventricular hypertrophy. [neuroophthalmology.ca]

Treatment

Treatment Treatment Options: No treatment has been reported. References Li L, Xiao X, Yi C, Jiao X, Guo X, Hejtmancik JF, Zhang Q. Confirmation and refinement of an autosomal dominant congenital motor nystagmus locus in chromosome 1q31.3-q32.1. [disorders.eyes.arizona.edu]

The third section, New Therapies for Congenital Nystagmus, presents basic genetic studies and clinical trials of drug and surgical treatment of those patients with infantile forms of nystagmus. [books.google.com]

[…] a larger treatment effect observed in patients with IIN compared to those with a secondary cause in a randomised placebo-controlled trial[20] Evidence in children is lacking 4) Surgical treatment Can be considered if a significant head posture/head turn [gene.vision]

This approach will enable the practitioner to make the most accurate diagnosis and choose the most effective treatment option. [books.google.ro]

Prognosis

Prognosis The course and prognosis of pediatric cataracts is highly variable. The likelihood and rate of progression is very difficult to predict. [eyewiki.aao.org]

Affected individuals should talk to their physician and medical team about their specific case, associated symptoms and overall prognosis. [rarediseases.org]

Prognosis Congenital nystagmus is usually a benign condition. It is not curable, but its symptoms can be diminished with spectacles or contact lenses. [healthofchildren.com]

Prognosis is excellent since spasmus nutans usually resolves by the age of 3 to 4 years. See-saw nystagmus. This form is clinically unique, with both vertical and torsional components. [aao.org]

Etiology

Nystagmus can be physiologic or pathologic according to etiology. [omicsonline.org]

Abstract Background: Most patients with pure nonprogressive congenital cerebellar ataxia have a sporadic form of unknown heredity and etiology. [neurology.org]

Etiology The causes of infantile cataracts have been the source of much speculation and research. Making a distinction between unilateral and bilateral cataracts may be useful when considering etiology. [eyewiki.aao.org]

Discussion The heterogeneity of congenital nystagmus has been well established on the basis of etiology, hereditary pattern, and waveforms. [healio.com]

Epidemiology

The Global Epidemiology of Hereditary Ataxiaand Spastic Paraplegia: A systematic review of prevalence studies. Neuroepidemiology 2014; 24:174-183. Ashizawa T, Figueroa KP, Perlman SL, et al. [rarediseases.org]

Epidemiology The exact incidence and prevalence of nystagmus is not known but it is thought to occur in about 1 in 1,000 people. [patient.info]

Fanconi analyzed its epidemiology and found that the virus was not transmitted by droplet infection, as previously assumed and his understanding of pathophysiologic connections culminated in his prediction that Down syndrome was due to a chromosomal abnormality [wikivisually.com]

Pathophysiology

While this distinction may be conceptually correct, it does not always reflect the underlying pathophysiology. [aao.org]

Acquired pendular nystagmus: its characteristics, localizing value, and pathophysiology. J. Neurol Neurosurg Psych 1982:45:431-439 Stahl JS, Rottach KG, Averbuch-Heller L, Maydell RD, Collins SD, Leigh RJ. [tchain.com]

The pathophysiology remains unclear although several mechanisms have been suggested. [healio.com]

Pathophysiology [ 1 ] The ocular motor system consists of the vestibular ocular nystagmus saccade system, the pursuit system, the fixation and gaze-holding system and the vergence system. [patient.info]

"Cerebellar ataxia: Pathophysiology and rehabilitation". Clinical Rehabilitation. 25 (3): 195–216. doi : 10.1177/0269215510382495. PMID 21321055. ^ "SCA2 information sheet from www.ataxia.org" (PDF). Archived from the original (PDF) on 2012-07-12. [en.wikipedia.org]

Prevention

An IOL can prevent the formation of a Sommering’s ring, but it is also easier for the lens epithelial cells to migrate to the center of the pupil. [eyewiki.aao.org]

Prevention In general nystagmus cannot be prevented. [healthofchildren.com]

Prevention Because some cases of Noonan syndrome occur spontaneously, there's no known way to prevent it. However, if you have a family history of this syndrome, talk to your doctor about the benefits of genetic counseling before you have children. [mayoclinic.org]

Early detection through regular eye examination and prompt treatment is essential to prevent vision loss. [afb.org]

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