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2.1
Convergence Nystagmus
Nystagmus Convergence

Presentation

A case of convergence nystagmus associated with an Arnold-Chiari type I malformation is presented. [ncbi.nlm.nih.gov]

Presents a more streamlined format to the printed text to help you focus on the clinically actionable information you need everyday. [books.google.de]

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]

When the esotropia was present, with versions there were bilateral abduction deficits. [collections.lib.utah.edu]

Entire Body System

  • Pseudotumor

    Pseudotumor cerebri (idiopathic intracranial hypertension) is an elevation of intracranial pressure in the absence of a mass lesion. [ajnr.org]

  • Swelling

    The etiology of the disk swelling is thought to be a disruption of axonal transport. Patients with true papilledema require urgent neurologic evaluation and brain MR imaging (or CT if the MR imaging is not immediately accessible). [ajnr.org]

Cardiovascular

  • Hypertension

    Description A 66-year-old woman who had a history of hypertension was admitted for sudden onset of binocular diplopia and unsteady gait. [casereports.bmj.com]

    […] month of age, but symptoms began in the 4th month of life, when he started losing weight By the time he was admitted weight was 6150g and he was 74cm tall, with an emaciated aspect, no panniculus adiposus, irritated, and with symptoms of intracranial hypertension [scielo.br]

    Review of Systems Negative Past Ocular History CRAO OS Ocular migraine with episodes of transient vision loss Past Medical History Cerebrovascular attack of the left operculum and posterior internal capsule (diagnosed, 2013) Pre-diabetes Hypertension [webeye.ophth.uiowa.edu]

    Pseudotumor cerebri (idiopathic intracranial hypertension) is an elevation of intracranial pressure in the absence of a mass lesion. [ajnr.org]

Musculoskeletal

  • Torticollis

    If vertical torticollis is present, the vertical rectus muscles can also be recessed. Asymptomatic eye movements do not require treatment. [aao.org]

    They can cause a manifest or latent reduction in visual acuity, torticollis and altered binocular vision. [fundacionmapfre.org]

    Congenital nystagmus is one of the main causes of torticollis [4]. Our purpose is to describe the abnormal head position that can be present in many patients with nystagmus from a clinical and a surgical point of view. [hindawi.com]

    It occurs with a unique triad of symptoms including pendular nystagmus, torticollis, and head nodding. The pendular nystagmus may be horizontal, vertical, torsional, or mixed. [dizzydoctor.com]

    It is often accompanied by head nodding and torticollis. All signs disappear during sleep. It is a benign condition, although space-occupying lesions (especially gliomas of the anterior visual pathway) can present in a similar way. [patient.info]

Ears

  • Benign Paroxysmal Positional Vertigo

    Nystagmus Benign paroxysmal positional vertigo Central positional nystagmus Positional alcohol nystagmus. [tchain.com]

    This is associated with vertigo, tinnitus and hearing loss. It may be found in acute labyrinthitis, Ménière's disease and benign paroxysmal positional vertigo. Vestibular nystagmus is often sporadic in these conditions. [patient.info]

    Nystagmus that is present only when induced by positional testing is a feature of benign paroxysmal positional vertigo, which is discussed elsewhere.2,7 It is possible to induce nystagmus in normal subjects with optokinetic or vestibular stimuli. [jnnp.bmj.com]

Eyes

  • Vertical Gaze Palsy

    Acute esotropia with contralateral supranuclear vertical gaze palsy and convergence-retraction nystagmus in patients with thalamomesencephalic lesion is rare.1 Damage to supranuclear fibres having an inhibitory effect on the convergence neurons or ischaemia [casereports.bmj.com]

    Convergence nystagmus and vertical gaze palsy of vascular origin. Rev Neurol (Paris) 2005;161:593–595. 6. Buuttner U, buuttner-Ennever JA, Rambold H, Helmchen C. The Contribution of midbrain circuits in the control of gaze. [synapse.koreamed.org]

    Parinaud's syndrome Other names Dorsal midbrain syndrome, vertical gaze palsy, upward gaze palzy, sunset sign,[1] setting-sun sign,[2] sun-setting sign,[3] sunsetting sign,[4] sunset eye sign,[5] setting-sun phenomenon[5] Specialty Neurology Parinaud's [en.wikipedia.org]

    There was no light-near dis...OMS Mesenecephalon, Convergence Reaction Nystagmus, Upgaze Palsy, Abnormal Range, Sixth Nerve Palsy, Vertical Gaze Palsy, Eyelid Retraction, OMS Dorsal Midbrain 6 Leukemic leptomeningeal carcinomatosis causing 4th and 6th [collections.lib.utah.edu]

  • Photophobia

    Presence of photophobia. Albinism and oculocutaneous albinism can lead to nystagmus that presents as sensory defect nystagmus. Exam Findings Visual acuity. [aao.org]

    In miners the eye movements are very rapid, increase on upward gaze, and are often associated with vertigo, head tremor, and photophobia. [medical-dictionary.thefreedictionary.com]

    There is often a family history of sensory deprivation and examination reveals poor vision, photophobia, abnormal pupillary reactions and optic neuropathy. High refractive error and retinopathy are common findings. [patient.info]

    An ocular examination should be performed with the best age dependant equipment available specifically looking for signs of photophobia, retinal dystrophy, retinal/choroidal hypopigmentation, iris transillumination and anterior segment anomaly e.g., cataract [nature.com]

Neurologic

  • Oscillopsia

    Some patients describe oscillopsia (the perception of continual movement of the visual environment). Generally, if a patient is unaware of oscillopsia, the nystagmus is likely to be congenital. [patient.info]

    Symptoms included diplopia and oscillopsia. [collections.lib.utah.edu]

    Base-in prisms alleviated symptoms of oscillopsia at near and improving reading visual acuity. [journals.lww.com]

    Supranuclear disorders can also cause nystagmus or nystagmus-like oscillations, which are unwanted eye movements that can degrade vision or cause oscillopsia. [neurology.mhmedical.com]

    Patients with acquired nystagmus are more likely to experience oscillopsia but the presence or absence of this symptom should not be considered diagnostic. [aop.org.uk]

  • Vertigo

    Part IV is a new section on the symptomatic treatment of vertigo. The third edition is thoroughly revised and has been expanded, covering the rapid advances that have occurred in the field in the last ten years. [books.google.de]

    The condition, benign positional vertigo, produces vertigo and nystagmus when the head is moved in certain directions. It can arise spontaneously or after a concussion. Motion sickness medicines sometimes help. [medical-dictionary.thefreedictionary.com]

    This is associated with vertigo, tinnitus and hearing loss. It may be found in acute labyrinthitis, Ménière's disease and benign paroxysmal positional vertigo. Vestibular nystagmus is often sporadic in these conditions. [patient.info]

    A small literature exists about this called "matitutional vertigo". Downbeating nystagmus can be elicited by the head-shaking test. [tchain.com]

  • Dizziness

    "Dizziness" is a complaint commonly heard by neurologists, otolaryngologists, and other health care providers, yet its origins are many and often difficult to pinpoint and to treat. [books.google.de]

    The patients, aged 21 and 64-years, visited our clinic because of sudden dizziness. There was no cochlear sign in either case. Neurotological examinations, including electronystagmography (ENG), were carried out. [jstage.jst.go.jp]

    dizziness, incoordination Lethargy, dizziness, headache Periodic Alternating Nystagmus Baclofen (5-10mg, tid) Memantine (5-10mg, qid) Drowsiness, dizziness, lethargy Lethargy, dizziness, headache Acquired Pendular Nystagmus in MS Gabapentin (300mg, [webeye.ophth.uiowa.edu]

    Ordinary testing for dizziness (such as an ENG or rotatory chai r testing) is difficult to interpret in persons with CN, and generally we tend to avoid doing it, except in difficult cases. [dizziness-and-balance.com]

    The patient may have dizziness (vertigo), nausea and vomiting, and nystagmus. Brain lesions. Disease in many parts of the brain can result in nystagmus. Alcohol and drugs. [medical-dictionary.thefreedictionary.com]

  • Hyperactivity

    Downbeat nystagmus is usually caused by lesion of cerebellar flocculus, which in turn resulting in disinhibition of SVN-VTT pathway, followed by relative hyperactivity which drive the upward slow-phase. [teddybrain.wordpress.com]

     Hyperactive after floccular lesions → DBN 81. [slideshare.net]

    The horizontal VOR is hyperactive (1276,1278) or normal (1283) Caloric tests frequently show increased responses, though a few may have absent caloric responses (1275). [neuroophthalmology.ca]

Workup

A thorough workup, including neuroimaging is essential to rule out anatomic lesions or other causes of this syndrome. Visually significant upgaze palsy can be relieved with bilateral inferior rectus recessions. [en.wikipedia.org]

Diagnosis, Workup and Treatment Given the patient’s motility deficits with convergence-retraction nystagmus, a lesion in the dorsal midbrain was suspected. [reviewofophthalmology.com]

We discuss the differential diagnosis, suggest a methodical approach to the diagnostic workup, and reveal the final diagnosis. [jamanetwork.com]

The prevalence of IN is estimated at 0.14%. 1 In most cases of IN, a thorough workup will reveal comorbid afferent visual system pathology. 8 Whether or not this can be said to ‘cause’ nystagmus is still a point of disagreement within the literature. [aop.org.uk]

It is necessary for this kind of nystagmus to perform a complete neurological and endocrinological workup. [intechopen.com]

Treatment

Part III presents differential diagnostic points that help the clinician decide on the cause and treatment of the patient's problem. Part IV is a new section on the symptomatic treatment of vertigo. [books.google.de]

Prism treatment When the above treatments fail and also in cases of phoria developing in presbyopes, elderly persons, and poorly motivated patients, prism treatment is undertaken. [kjophthal.com]

The immediate-treatment group showed a 14 percent decrease in number of attacks than the delayed-treatment group. The Presenting with a CIS (PRECISE) study treated patients with unifocal CIS and abnormal MRI with 20 mg/day of glatiramer acetate. [reviewofophthalmology.com]

Prognosis

Abstract Retraction-convergence nystagmus is a classic finding in extensive and bilateral lesions of the dorsal midbrain, usually neoplastic and, as such, considered to signal a poor prognosis. [ncbi.nlm.nih.gov]

Treatment and prognosis Highly variable and depend on the etiology 2. Promoted articles (advertising) [radiopaedia.org]

Prognosis[edit] The eye findings of Parinaud's syndrome generally improve slowly over months, especially with resolution of the causative factor; continued resolution after the first 3–6 months of onset is uncommon. [en.wikipedia.org]

The visual prognosis is reasonably good, but if the head turn is excessive, extraocular muscle surgery may be needed. [medical-dictionary.thefreedictionary.com]

Etiology

Highly variable and depend on the etiology, but the lesion will be affecting the medial midbrain or pons of the brainstem 3,5,8. Treatment and prognosis Highly variable and depend on the etiology 2. Promoted articles (advertising) [radiopaedia.org]

The etiology of abnormal vertical eye movements and convergence nystagmus is discussed with emphasis on the neurotological examinations and MRI. [jstage.jst.go.jp]

However, the most common causes are pineal region tumors, brainstem hemorrhage, and ischemic infarction.[1][4][7] Pineocytoma and germinoma account for up to 40% of all the tumors causing PS.[1][8] The etiology of PS is also correlated with patient age [eyewiki.aao.org]

The most common etiology is a pituitary tumor. Other etiologies include craniopharyngioma, meningioma, aneurysm, glioma, inflammation, MS, and ischemia, as can be seen with lupus or giant cell arteritis. [ajnr.org]

English: BL blood CF cerebrospinal fluid CI chemically induced CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology EH ethnology ET etiology [decs.bvs.br]

Epidemiology

2000 Allowable Qualifiers English: BL blood CF cerebrospinal fluid CI chemically induced CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology [decs.bvs.br]

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]

Pathophysiology

Affiliations PMID: 12037438 DOI: 10.1159/000057905 Case Reports Pathophysiologic mechanism of convergence nystagmus Ken Johkura et al. Eur Neurol. 2002. [pubmed.ncbi.nlm.nih.gov]

The co-development of convergence, convergence-evoked, and convergence-retraction nystagmus, and pretectal pseudobobbing in our patient indicates that these ocular movements may share common pathophysiology of imbalance in the vergence system.Key Words [jkna.org]

However, it does not mean that we cannot narrow down our diagnoses; by the existence of postulated hypothesis for the pathophysiology of nystagmus, we can somehow localize the lesion. [teddybrain.wordpress.com]

An unusual variant of the dorsal midbrain syndrome in MS: Clinical characteristics and pathophysiologic mechanisms. Mult Scler 2004;10:322-5. 5. Masjuan J, Alvarez-Cermeño JC, García-Barragán N, et al. [reviewofophthalmology.com]

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

Prevention

Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. ‎ [books.google.es]

It is a sphingosine 1-phosphate receptor modulator that blocks the release of lymphocytes from lymph nodes preventing their recirculation into the CNS. [reviewofophthalmology.com]

[…] diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology EH ethnology ET etiology GE genetics HI history IM immunology ME metabolism MI microbiology MO mortality NU nursing PS parasitology PA pathology PP physiopathology PC prevention [decs.bvs.br]

The physician should be attentive to the possible masking and simulation by the patient during the examination, making him understand that a wrong assessment can mean a preventable worsening that may have an impact for his health. [fundacionmapfre.org]

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2.1
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