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Hereditary Nystagmus
Nystagmus Hereditary

Presentation

In this paper, the authors present a case study of a patient whose nystagmus has a strong and exclusive male hereditary component. Genetic argumentation is presented in support of this conclusion. [ncbi.nlm.nih.gov]

It is present physiologically in everyone to a minor degree under certain conditions but it is often pathologic when exaggerated movements are present during normal visual activities. [disorders.eyes.arizona.edu]

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

Inheritance - congenital achromatopsia is transmitted in an autosomal-recessive trait Presentation - patients present in early childhood with nystagmus, abnormal visual behaviour or photophobia. Acuity is less than 20/200. [patient.info]

Entire Body System

  • Pain

    Arm pain; Cranial nerve anomalies; Burning pain in the limbs; Loss of pain and temperature in a cape-like distribution; Touch, vibration, and limb position may or may not be affected; Segmental sensory loss, especially of pain and temperature; Paresthesias [genome.jp]

    Moving from inside to outside, switching lights on and off, moving in foggy or cloudy days, and crossing in front of car headlamps produce a painful dazzling that reduces visual acuity and causes uncertainty in movement. [aniridia.eu]

    Narrative Medicine Nephrology Neurology Neuroscience and Psychiatry Notable Notes Nursing Nutrition Nutrition, Obesity, Exercise Obesity Obstetrics and Gynecology Occupational Health Oncology Ophthalmic Images Ophthalmology Orthopedics Otolaryngology Pain [jamanetwork.com]

    Severe photophobia can be quite painful, even in relatively dim light. [tsbvi.edu]

    (This test is not painful or harmful to the child.) Patients are routinely videotaped for further analysis. The general behavior of the child at the time of the test is also assessed. [shileyeye.ucsd.edu]

  • Weakness

    […] atrophy leading to: Wheelchair confinement (95%, typically 11-25 yrs) Cerebellar dysarthria Impaired swallowing Bladder dysfunction Eye movement (nystagmus), vision loss (5-15%) Loss of position and vibration sense (posterior column degeneration) Distal weakness [pedclerk.bsd.uchicago.edu]

    Each had variable clinical features, including segmental loss of pain and temperature sensation, muscle weakness and atrophy of the upper limbs and hands, nystagmus, urinary incontinence, and lower limb hyperreflexia and spasticity. [genome.jp]

    Progressive external ophthalmoplegia (PEO) is characterized by weakness of the eye muscles. [blueprintgenetics.com]

    You might have dizziness (vertigo), fatigue and muscle weakness during your episodes. In some cases, symptoms resolve in later life. Episodic ataxia doesn't shorten life span, and symptoms might respond to medication. [mayoclinic.org]

    An adduction weakness on conjugate movements and a jerk nystagmus of the abducting eye are the classic ocular motor signs (‘dissociated nystagmus’). [ncbi.nlm.nih.gov]

  • Fatigue

    Occupational) Muscle Paretic (Myasthenic) Optokinetic (Induced, Optomotor, Panoramic, Railway, Sigma) Optokinetic After-Induced (Post-Optokinetic, Reverse Post-Optokinetic) Pendular (Talantropia) Periodic/Aperiodic Alternating Physiologic (End-Point, Fatigue [dwidude.com]

    You might have dizziness (vertigo), fatigue and muscle weakness during your episodes. In some cases, symptoms resolve in later life. Episodic ataxia doesn't shorten life span, and symptoms might respond to medication. [mayoclinic.org]

    This nystagmus can increase in size and frequency when the patient is tired, sick, or fatigued. Some very young patients are noted to have head nodding or head shaking, but these usually disappear over time. [disorders.eyes.arizona.edu]

    Monocular vision Reduced visual field Reduced depth perception May develop blindness in one eye Reduced visual-motor abilities Eye fatigue with close or detailed work Frequent breaks Seating should favor functional eye. [tsbvi.edu]

    A change in the speed of the nystagmus leading to a decrease in vision can be related to stress, the patient’s emotional state, fatigue, the direction of view or when one eye is covered. [lowvision.org]

  • Falling

    These children continue to "fall through the cracks" of our medical education system. [books.google.com]

    Historically, X-linked ocular albinism is also called Nettleship-Falls ocular albinism, after the two physicians who defined its X-linked inheritance. [visionofchildren.org]

    […] lesions of the optic chiasm (e.g. pituitary tumours) and achiasma (note that this is a rare form of pendular nystagmus in which the torsional components are conjugate and the vertical components are disjunctive—one eye rises and intorts while the other falls [ncbi.nlm.nih.gov]

    Congenital Stationary Night Blindness Iris Pigmentation Foveal Hypoplasia Background Congenital nystagmus (CN) is the common symptom of a range of diseases involving the macula from infancy on, and includs at least three X-linked disorders: Nettleship-Falls [bmcgenet.biomedcentral.com]

    In the SCA patient, the ocular fixation positions frequently did not fall exactly on the visual target, but landed at points somewhat removed from the target (saccadic dysmetria). [journals.plos.org]

  • Anorexia

    Fever, anorexia, nausea and vomiting, lymphadenopathy and skin hyperpigmentation may occur. There can be pleural effusions and lobar infiltrates (1257). [neuroophthalmology.ca]

Gastrointestinal

  • Diarrhea

    […] disorders and combination [ edit ] Sources of toxicity that could lead to nystagmus: Thiamine deficiency [ edit ] Risk factors for thiamine deficiency, or beri beri, in turn include a diet of mostly white rice, as well as alcoholism, dialysis, chronic diarrhea [en.wikipedia.org]

    The most common are a transient migratory polyarthralgia, sometimes with true arthritis, abdominal pain, weight loss and a malabsorptive type of diarrhea, often misdiagnosed as irritable bowel syndrome (1248,1260). [neuroophthalmology.ca]

  • Abdominal Pain

    The most common are a transient migratory polyarthralgia, sometimes with true arthritis, abdominal pain, weight loss and a malabsorptive type of diarrhea, often misdiagnosed as irritable bowel syndrome (1248,1260). [neuroophthalmology.ca]

Musculoskeletal

  • Fracture

    Photophobia Fracturing of light (like looking through broken glass) Increased glare Blurred vision Reduced acuity Blindness May need to use sunglasses, visors, or hats outdoors and indoors as well Reduced or diffused lighting Sunglasses, visors or hats [tsbvi.edu]

Eyes

  • Strabismus

    Strabismus in Adults Although strabismus is much more common in children, many adults have strabismus, either since childhood or developed in adult life. [shileyeye.ucsd.edu]

    […] may develop as a result of strabismus). [dukehealth.org]

    Simon also served a fellowship in pediatric ophthalmology and strabismus at the Wills Eye Hospital, Philadelphia. ... PAMELA KAW, M.D., is a fellow in pediatric ophthalmology and strabismus at Albany Medical College. [aafp.org]

    Effects on vision may include decreased visual acuity, photophobia, nystagmus, and strabismus. ANIRIDIA Aniridia is a hereditary condition where the iris of the eye is underdeveloped. [nfb.org]

    Strabismus 22: 81-85. Brodsky MC, Dell'Osso LF2 (2014) A unifying neurologic mechanism for infantile nystagmus. JAMA Ophthalmol 132: 761-768. [omicsonline.org]

  • Esotropia

    Esotropia The most common type of strabismus is esotropia, which occurs when either one or both eyes turn in toward the nose. Some children are born with this condition. More frequently, it starts at about age 2 1/2. [shileyeye.ucsd.edu]

    It is often seen in patients with congenital esotropia and following surgery for infantile esotropia, probably resulting from subnormal binocular interaction. [emedicine.medscape.com]

    An infant with a constant large-angle esotropia can be referred even earlier. [aafp.org]

    Epicanthus can obscure the inner canthus giving rise to the appearance of esotropia when none is present. [slideshare.net]

  • Visual Acuity Decreased

    Effects on vision include decreased visual acuity, decreased central vision, decreased sensitivity in all visual fields, and nystagmus. OPTIC NERVE HYPOPLASIA (ONH) ONH is generally of unknown cause. [nfb.org]

    May have decreased visual acuity May have better acuity In one eye than in the other May have nystagmus May have strabismus May have variable field restrictions Visual perception may be impaired High illumination High contrast Enlarged printed materials [tsbvi.edu]

Skin

  • Flushing

    Cold or warm water flushed into the ear canal will generate motion signals from the inner ear. The eyes will respond to this signal with nystagmus if the pathways are intact. Causes and symptoms There are many causes of nystagmus. [medical-dictionary.thefreedictionary.com]

  • Hyperpigmentation

    Fever, anorexia, nausea and vomiting, lymphadenopathy and skin hyperpigmentation may occur. There can be pleural effusions and lobar infiltrates (1257). [neuroophthalmology.ca]

  • Photosensitivity

    Patients with infantile nystagmus due to albinism may have a positive family history and often appear photosensitive. A history of infantile strabismus increases the likelihood of latent or manifest latent nystagmus. [emedicine.medscape.com]

Psychiatrical

  • Psychomotor Retardation

    Three groups of patients with INS were individualized: group 1 (n=34) - neurologic nystagmus (associated with neurological context: fetal suffering, psychomotor retardation, epilepsy.); group 2 (n=23) - sensory nystagmus (with disease of visual system [iovs.arvojournals.org]

Neurologic

  • Nystagmus

    See Caloric nystagmus, Irritative nystagmus, Paralytic nystagmus, Recovery nystagmus, Opticokinetic nystagmus, Seesaw nystagmus. nys·tag·mus ( nis-tag'mŭs ) Rhythmic oscillation of the eyeballs, either pendular or jerky. [medical-dictionary.thefreedictionary.com]

    If the nystagmus is horizontal, the eye movement is usually "to-and-fro". [disorders.eyes.arizona.edu]

    Our present understanding of the genetics of hereditary nystagmus is somewhat limited. Few published medical sources have documented the existence of true cases of sex-linked hereditary nystagmus. [ncbi.nlm.nih.gov]

    Although the nystagmus frequency was also gaze-angle dependent, it was equal in both eyes. In the null region both nystagmus amplitude and frequency were minimal and equal for the two eyes. [journals.lww.com]

  • Involuntary Movements

    It is a type of bilateral involuntary eye movement disorder usually manifest as a slow movement in one direction and a rapid motion in the other direction. [disorders.eyes.arizona.edu]

    Typical head tilt in a DSH female with Vestibular syndrome and secondary nystagmus Nystagmus is a neurological disease where there is an involuntary movement of one of both eyes. [vetbook.org]

    Nystagmus, a condition in which the eye has rhythmic and involuntary movement or oscillation, is often caused by an underlying neurological or ocular disorder. [livestrong.com]

    Nystagmus is a classified eye disease where the patient experiences an involuntary movement of the eyes in which they oscillate from side to side, up and down or even in a circular motion. [simmonsoptometrists.co.uk]

  • Pendular Nystagmus

    Associated with congenital blindness. optokinetic nystagmus nystagmus induced by looking at objects moving across the field of vision. oscillatory nystagmus pendular nystagmus. pendular nystagmus that which consists of to-and-fro movements of equal velocity [medical-dictionary.thefreedictionary.com]

    SPONTANEOUS NYSTAGMUS Vestibular imbalance nystagmus Acquired pendular nystagmus Horizontal Vertical See-saw Congenital Nystagmus Latent nystagmus (LN) Pendular type Jerk type Convergence/Retraction nystagmus Divergence nystagmus Periodic alternating [tchain.com]

    Identifier 163-9-4 Title Familial Nystagmus Ocular Movements Congenital Nystagmus; Horizontal Pendular Nystagmus; Infantile Nystagmus Syndrome; Familial Congenital Nystagmus Creator Shirley H. [collections.lib.utah.edu]

    Dissociation is common with pendular nystagmus. Acquired pendular nystagmus is dysconjugate in both size and direction in half of cases (Video “acquired pendular nystagmus” ). [neuroophthalmology.ca]

    An acquired pendular nystagmus can occur in any plane; it can be monocular or have a greater intensity in one eye and typically remains pendular in all directions of gaze. [ncbi.nlm.nih.gov]

  • Dysarthria

    Causes - Hereditary paroxysmal cerebral ataxia * Dizziness * Dysarthria * Impaired balance * Incoordination * Migraine * Nystagmus * Slurred speech * Unsteadiness * Vertigo * Visual disturbance Prevention - Hereditary paroxysmal cerebral ataxia Not supplied [checkorphan.org]

    Complications CNS : Degeneration of posterior column and spinocerebellar tracts +/- cerebellar atrophy leading to: Wheelchair confinement (95%, typically 11-25 yrs) Cerebellar dysarthria Impaired swallowing Bladder dysfunction Eye movement (nystagmus) [pedclerk.bsd.uchicago.edu]

    Other signs and symptoms that might develop as the disease progresses include slow, slurred speech (dysarthria); fatigue; rapid, involuntary eye movements (nystagmus); spinal curvature (scoliosis); hearing loss; and heart disease, including heart enlargement [mayoclinic.org]

    Cranial nerve anomalies; Burning pain in the limbs; Loss of pain and temperature in a cape-like distribution; Touch, vibration, and limb position may or may not be affected; Segmental sensory loss, especially of pain and temperature; Paresthesias; Dysarthria [genome.jp]

    […] dystrophy, Morning glory disc anomaly, Foveal hypoplasia, Aniridia, Optic nerve hypoplasia, Peters anomaly AD 144 550 PHOX2A Fibrosis of extraocular muscles, congenital, 2 AR 3 5 POLG POLG-related ataxia neuropathy spectrum disorders, Sensory ataxia, dysarthria [blueprintgenetics.com]

  • Somnolence

    Arousal disturbances such as paroxysmal (1258) or progressive (1249) somnolence, insomnia, narcolepsy and cataplexy (1258,1260) are mentioned. [neuroophthalmology.ca]

Workup

This innovative one-page format provides the definition, differential diagnosis, workup and diagnosis, and treatment options for nearly 170 diseases and disorders. [books.google.com]

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]

Treatment

Treatment Treatment Options: Congenital nystagmus cannot be cured. However, several treatments may be beneficial. Glasses and contact lenses, and, occasionally, extraocular muscle surgery may be helpful. [disorders.eyes.arizona.edu]

What treatments are available for Nystagmus? Unfortunately, there are not many good treatments for nystagmus. For some specific types, medicines can help and surgery can be used to improve certain features, but for most, little treatment exists. [rnib.org.uk]

Current treatments, such as prism glasses, acupuncture, electronic nerve stimulation, contact lenses, various drug treatments, and others have had limited success. [clinicaltrials.gov]

At present, there is no treatment for this condition. [afb.org]

Prognosis

Prognosis - there is no progression. [patient.info]

Diagnosis and Prognosis: Pediatricians and ophthalmologists are likely to make this diagnosis. It is important that complete physical and neurological examinations are done to rule out other conditions with which nystagmus is associated. [disorders.eyes.arizona.edu]

Prognosis - Hereditary paroxysmal cerebral ataxia Not supplied. Treatment - Hereditary paroxysmal cerebral ataxia Not supplied. Resources - Hereditary paroxysmal cerebral ataxia Not supplied. [checkorphan.org]

Hereditary motor and sensory neuropathy: Roussy-Levy variant Carlevoix-Saguenay - early childhood onset of cerebellar ataxia, pyramidal tract signs, and peripheral neuropathy Infantile onset spinocerebellar ataxia- ataxia, opthalmoplegia, hearing loss Prognosis [pedclerk.bsd.uchicago.edu]

Etiology

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

Eye injuries in childhood: demography, etiology, and prevention. Pediatrics. 1989;84:438–41. Copyright © 2001 by the American Academy of Family Physicians. This content is owned by the AAFP. [aafp.org]

Etiology Congenital Disease/Diagnosis Familial Infantile Nystagmus Syndrome Treatment Surgical procedures for congenital nystagmus are discussed in ref 8 References 1.. [collections.lib.utah.edu]

This is in contrast to other etiologies of congenital corneal clouding like Peter’s anomaly or a limbal dermoid, which can vary in size/location and often obscure underlying iris. [reviewofophthalmology.com]

The findings established several forms of spinal cord syrinxes with different etiologies and pathogenesis. Levine (2004) proposed a novel theory of the pathogenesis of syringomyelia associated with lesions at the foramen magnum. [genome.jp]

Epidemiology

Congenital eye malformations: clinical-epidemiological analysis of 1,124,654 consecutive births in Spain. Am J Med Genet 1998;75:497-504. 4. Al-Ghamdi A, Al-Rajhi A, Wagoner MD. [reviewofophthalmology.com]

Treatment consist of learning compensatory strategies to take over for the impaired system. [ citation needed ] Epidemiology [ edit ] Nystagmus is a relatively common clinical condition, affecting one in several thousand people. [en.wikipedia.org]

Pathophysiology

Research over the past three decades has led to better understanding of the pathophysiology of acquired forms of nystagmus, suggesting drug therapies. [ncbi.nlm.nih.gov]

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

Nystagmus Pathophysiology of Nystagmus An article on nystagmus Learning Objectives: to discuss the relationship between eye movements and clear vision. to understand three mechanisms that normally hold gaze steady: visual fixation, the vestibulo-ocular [lowvision.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 is a result of inadequate endothelium, and treatment therefore requires replacing the endothelium. [reviewofophthalmology.com]

Prevention

Appropriate eye muscle surgery may be indicated when a significant head deviation is present to prevent secondary changes in neck muscles that may not be correctable later. [disorders.eyes.arizona.edu]

Causes - Hereditary paroxysmal cerebral ataxia * Dizziness * Dysarthria * Impaired balance * Incoordination * Migraine * Nystagmus * Slurred speech * Unsteadiness * Vertigo * Visual disturbance Prevention - Hereditary paroxysmal cerebral ataxia Not supplied [checkorphan.org]

Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment Adherence United States Preventive [jamanetwork.com]

Low Vision specialists also use special testing techniques during the refraction to measure the eyeglass prescription and prevent inaccurate results from latent nystagmus. [lowvision.org]

It is the leading cause of preventable blindness worldwide. [tsbvi.edu]

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