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Query: UMLS:C0028738 (nystagmus)
 7,431 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of a 42-year old man with a bilateral medial medullary stroke (MMS) with favorable outcome. First described by Spiller in 1908, the MMS accounts for less than 0,5% of all cerebral infarcts. It may be unilateral or more rarely bilateral, and may often be the consequence of the atherosclerosis. The clinical features of MMS classically associate contralateral hemiparesis and lemniscal hypoesthesia accompanied by ipsilateral lingual palsy and sometimes oculomotor disturbances (upbeat nystagmus). With the advent of magnetic resonance imaging, some restricted or unusual clinical manifestations can be attributed to this localization. The benign form of MMS seems much more common than MMS with poor prognosis.
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PMID:[Bilateral medial medullary infarction]. 1079 16

The aim of this study was to evaluate the incidence of visual function abnormalities in children with infantile hemiplegia, and the relation between visual abnormalities and type of lesion, as shown by brain MRI. Visual function was tested (grating acuity, visual field size, binocular optokinetic nystagmus [OKN], and ocular movements) in a group of 47 children with congenital or early acquired hemiplegic cerebral palsy (mean age 25 months, range 8 to 52 months). The cohort was subdivided into four groups according to MRI findings: brain malformations (n=5), abnormalities of the periventricular white matter (n=20), cortical-subcortical lesions (n=16), and non-progressive postnatal brain injuries (n=6). More than 80% of the children showed abnormal results in at least one visual test: acuity was the least impaired function, while visual field and OKN were abnormal in more than 50% of the cohort. No specific correlation could be identified between the type and timing of the lesions and visual function. Unlike adults with stroke, visual field defects were not always related to contralateral damage in the optic radiations or in the visual cortex. These results indicate that visual abnormalities are common in children with hemiplegia, and that they cannot always be predicted by MRI. All children with hemiplegia need a detailed assessment of visual function.
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PMID:Visual function in children with hemiplegia in the first years of life. 1136 85

We investigated nystagmus elicitation in 50 normal subjects who were exposed interaurally to linear acceleration with step (rectangular) and sinusoidal modes of oscillation using a linear accelerator. Relatively strong G-loads of 0.3-0.5 G at a 10 m stroke were applied to subjects who looked at a memorized target in darkness, with the head and trunk tightly restrained in the upright sitting position. Horizontal and vertical eye movements were recorded by electrooculography (EOG). Various levels of G-directional preponderance (DP), including completely one-sided, were observed similarly in either stimulus mode, strongly suggesting that directional asymmetry in nystagmus elicitation may be a functional characteristic in the otolith-ocular response, in contrast to the canal-ocular response. The effects of G-load increase were less congruent between the two stimulus modes. In the step-mode oscillation, the desaccaded slow eye position which corresponds to the vestibuloocular reflex (VOR) was saw-toothed in shape as was the stimulus velocity curve, but the baseline often drifted slowly and DP-dependently in the direction opposite to the fast phase of nystagmus. When the slow phase velocity (SPV), a slope of the saw-tooth, was adjusted mathematically for such slow drift, it revealed that the adjusted SPVs were almost symmetrical between rightward and leftward G-directions. These results suggest that DP generation is separate from VOR generation which is primarily symmetrical.
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PMID:Directional asymmetry of nystagmus elicitation in humans during step and sinusoidal modes of lateral linear acceleration. 1153 99

The effects of the anticonvulsant gabapentin were measured on vision and eve movements in three patients with acquired pendular nystagmus. In two patients, the nystagmus was associated with multiple sclerosis and, in the other, it followed brainstem stroke. A single oral 600 mg dose of gabapentin produced improvement of vision due to changes in ocular oscillations in all three patients. The effect was sustained after five weeks of treatment in two patients who elected to continue taking gabapentin 900-1500 mg/day. The results of this pilot study suggest that a controlled trial of gabapentin should be conducted to evaluate its role in the treatment of acquired forms of nystagmus.
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PMID:A pilot study of gabapentin as treatment for acquired nystagmus. 1153 72

Neuropathic pain, whether of peripheral or central origin, is characterized by a neuronal hyperexcitability in damaged areas of the nervous system. In peripheral neuropathic pain, damaged nerve endings exhibit abnormal spontaneous and increased evoked activity, partly due to an increased and novel expression of sodium channels. In central pain, although not explored in detail, the spontaneous pain and evoked allodynia are also best explained by a neuronal hyperexcitability. The peripheral hyperexcitability is due to a series of molecular changes at the level of the peripheral nociceptor, in dorsal root ganglia, in the dorsal horn of the spinal cord, and in the brain. These changes include abnormal expression of sodium channels, increased activity at glutamate receptor sites, changes in gamma-aminobutyric acid (GABA-ergic) inhibition, and an alteration of calcium influx into cells. The neuronal hyperexcitability and corresponding molecular changes in neuropathic pain have many features in common with the cellular changes in certain forms of epilepsy. This has led to the use of anticonvulsant drugs for the treatment of neuropathic pain. Carbamazepine and phenytoin were the first anticonvulsants to be used in controlled clinical trials. Studies have shown these agents to relieve painful diabetic neuropathy and paroxysmal attacks in trigeminal neuralgia. Subsequent studies have shown the anticonvulsant gabapentin to be effective in painful diabetic neuropathy, mixed neuropathies, and postherpetic neuralgia. Lamotrigine, a new anticonvulsant, is effective in trigeminal neuralgia, painful peripheral neuropathy, and post-stroke pain. Other anticonvulsants, both new and old, are currently undergoing controlled clinical testing. The most common adverse effects of anticonvulsants are sedation and cerebellar symptoms (nystagmus, tremor and incoordination). Less common side-effects include haematological changes and cardiac arrhythmia with phenytoin and carbamazepine. The introduction of a mechanism-based classification of neuropathic pain, together with new anticonvulsants with a more specific pharmacological action, may lead to more rational treatment for the individual patient with neuropathic pain.
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PMID:Anticonvulsants in neuropathic pain: rationale and clinical evidence. 1188 43

Functional nystagmic eye movements are compensatory responses meant to stabilize the gaze during head movement. Niven et al. (1966) have reported that otolithic nystagmus can be elicited by linear acceleration in humans only along interaural (Y-axis) acceleration (Gy), but not along occipitonasal (X-axis) or head-to-foot (Z-axis) acceleration. This result was reexamined in the present study in normal subjects who elicited lateral (Gy) nystagmus frequently. The nystagmic elicitation was examined by EOG in 4 healthy subjects who were fastened tightly in the chair of a linear accelerator and instructed to look straight ahead at an imaginary target in the dark. The stimulation was five oscillations of a constant 10-m stroke at two different acceleration levels of 0.3 and 0.5 G in a step mode. The X- and Z-axis accelerations did not induce any horizontal or vertical nystagmus, while the Y-axis acceleration did, in agreement with the above report. However, it was found that nystagmic elicitation due to Gy loading tended to be lower in the supine than in the upright sitting position. The present finding that nystagmic slow-phase velocity (SPV) increased with an increase in the G-load also contradicted the above report. Upright subjects who showed G-directional preponderance (DP) in nystagmic elicitation did not always maintain DP when supine. No relation could be seen between DP and SPV, suggesting that DP might be generated by a central mechanism different from SPV control.
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PMID:Influence of postural changes on nystagmic elicitation induced by linear acceleration. 1222 78

The male proband reported here was born with appropriate anthropometric parameters at term as the second child of healthy nonconsanguineous parents. His only clinical symptom was bilateral congenital cataracts with strabismus at birth, and both lenses were removed surgically at the age of 8 months. The perinatal and infantile period thereafter was clinically uneventful and his psychomotor development appeared almost normal. At the age of 6 years he was hospitalized for slight muscle weakness, minor ptosis, nystagmus and decreased physical activity. Soon after, his general condition worsened, gait ataxia presented, dysphagia and difficulty of speech followed by rapidly progressive generalized ataxia, and myopathy developed. Typical progressive gray matter degeneration with focal necrosis in the basal ganglia characteristic of the Leigh type of neuropathology could be detected by cranial MRI, the muscle histology showed ragged-red fibers. At the age of 7.5 years, unexpected left side hemiparesis with speech disability resembling that seen in MELAS syndrome developed, from which he recovered within 1.5 days. The mtDNA of the patient showed single 6.7 kb large-scale deletion harboring between 7817 and 14 536 bp. This case represents the first report of a verified mtDNA mutation associated with congenital cataracts as the first clinical sign of a later developing progressive neuromuscular disease presented with a combination of Leigh neuropathology, ragged-red fiber histopathology and stroke-like attack.
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PMID:Congenital cataract as the first symptom of a neuromuscular disease caused by a novel single large-scale mitochondrial DNA deletion. 1273 42

The association of internuclear ophthalmoplegia (INO) with torsional nystagmus is rare. We report a case of a 72-year-old male who developed brainstem stroke and was found to have left INO with torsional nystagmus. An MRI correlation in this case has been described.
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PMID:Internuclear ophthalmoplegia and torsional nystagmus: an MRI correlate. 1457 Oct 25

The somatosensory (haptic) vertical (HV) and visual vertical (VV) were assessed in two patients with vestibular nuclear lesions. Patient 1 had paroxysmal nystagmus, and was tested "on" and "off." The HV was normal "on" and "off" but the VV was severely tilted during vestibular paroxysms. Patient 2, with a brainstem stroke, was tested at months 1 and 6. The VV was severely tilted on both occasions (>12 degrees) but the HV was marginally tilted (4 degrees) in the acute stage only. These VV-HV dissociations suggest that vestibular nuclear lesions influence gravity perception mostly via ocular torsional effects rather than by disrupting a single, internal representation of verticality.
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PMID:Dissociation of visual and haptic vertical in two patients with vestibular nuclear lesions. 1461 Jan 15

This paper reviews a variety of abnormal eye movements which include abnormal ocular positions, restricted eye motions, impairment of conjugated eye movements, abnormal smooth pursuit, abnormal saccade, gaze-evoked nystagmus, down-beat nystagmus, internuclear ophthalmoplegia, supranuclear ophthalmoplegia, square wave jerks, roving eye movement, ocular bobbing, ocular dipping, reverse ocular bobbing, and ping-pong gaze. Abnormal eye movements occur from stroke, spinocerebellar degeneration, Parkinson disease, multiple system atrophy, progressive supranuclear palsy, multiple sclerosis, Miller Fisher syndrome, myasthenia gravis, opsoclonus-polymyoclonia syndrome, and Creutzfeldt-Jakob disease. In neurological practice, it is important to observe abnormal eye movements accurately and enthusiastically, to make appropriate anatomical and etiological diagnosis.
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PMID:[Clinical aspects of abnormal eye movements]. 1515 59


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