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Pathologic Nystagmus

Involuntary movements of the eye that are divided into two types, jerk and pendular. Jerk nystagmus has a slow phase in one direction followed by a corrective fast phase in the opposite direction, and is usually caused by central or peripheral vestibular dysfunction. Pendular nystagmus features oscillations that are of equal velocity in both directions and this condition is often associated with visual loss early in life. (Adams et al., Principles of Neurology, 6th ed, p272)
Also Known As:
Nystagmus, Pathologic; Conjugate Nystagmus; Dissociated Nystagmus; Fatigable Positional Nystagmus; Multidirectional Nystagmus; Non-Fatigable Positional Nystagmus; Permanent Nystagmus; Rebound Nystagmus; Retraction Nystagmus; Rotational Nystagmus; Spontaneous Ocular Nystagmus; Symptomatic Nystagmus; Temporary Nystagmus; Unidirectional Nystagmus; Non Fatigable Positional Nystagmus; Nystagmus, Conjugate; Nystagmus, Convergence; Nystagmus, Dissociated; Nystagmus, Fatigable Positional; Nystagmus, Horizontal; Nystagmus, Jerk; Nystagmus, Multidirectional; Nystagmus, Non-Fatigable Positional; Nystagmus, Pendular; Nystagmus, Periodic Alternating; Nystagmus, Permanent; Nystagmus, Rebound; Nystagmus, Retraction; Nystagmus, Rotary; Nystagmus, Rotational; Nystagmus, See-Saw; Nystagmus, Spontaneous Ocular; Nystagmus, Symptomatic; Nystagmus, Temporary; Nystagmus, Unidirectional; Nystagmus, Vertical; Ocular Nystagmus, Spontaneous; Positional Nystagmus, Non-Fatigable; See Saw Nystagmus; Convergence Nystagmus; Horizontal Nystagmus; Jerk Nystagmus; Pendular Nystagmus; Periodic Alternating Nystagmus; Rotary Nystagmus; See-Saw Nystagmus; Vertical Nystagmus
Networked: 207 relevant articles (21 outcomes, 15 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1. Pathologic Nystagmus
2. Multiple Sclerosis
3. Tremor (Tremors)
4. Myoclonus (Nocturnal Myoclonus)
5. Demyelinating Diseases (Demyelinating Disease)

Experts

1. Leigh, R John: 7 articles (02/2012 - 04/2002)
2. Strupp, Michael: 5 articles (01/2017 - 02/2006)
3. Brandt, Thomas: 4 articles (07/2013 - 02/2006)
4. Rucker, Janet C: 3 articles (10/2019 - 01/2005)
5. Kim, Ji-Soo: 3 articles (01/2019 - 10/2015)
6. Shaikh, Aasef G: 3 articles (04/2017 - 07/2011)
7. Thurtell, Matthew J: 3 articles (02/2012 - 12/2010)
8. Tilikete, Caroline: 2 articles (01/2020 - 08/2005)
9. Vighetto, Alain: 2 articles (01/2020 - 08/2005)
10. Kim, Sung-Hee: 2 articles (01/2019 - 10/2015)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Pathologic Nystagmus:
1. Gabapentin (Neurontin)FDA LinkGeneric
2. Memantine (Namenda)FDA Link
3. BaclofenFDA LinkGeneric
4. 4-Aminopyridine (4 Aminopyridine)FDA Link
10/01/2019 - "Specific recent advances in the study of nystagmus and saccadic intrusions include (1) improved understanding of the underlying etiologies and mechanisms of nystagmus enhanced or unmasked by provocative maneuvers such as supine position or head shaking; (2) recognition of the differences in behavior and treatment responsivity of acquired pendular nystagmus in demyelinating disease versus oculopalatal myoclonus; (3) recognition that oculopalatal myoclonus results from a dual mechanism of abnormal inferior olivary gap junction connection formation and maladaptive cerebellar learning; and (4) well-controlled clinical trials to evaluate the efficacy of pharmacologic interventions, such as memantine for acquired pendular nystagmus and 4-aminopyridine for downbeat nystagmus. "
02/01/2011 - "Controlled studies found gabapentin and memantine to be effective in acquired pendular nystagmus and early-onset idiopathic nystagmus, and an efficacy of 4-aminopyridine in downbeat nystagmus."
11/01/2021 - "Examples of drug treatment are the use of 4-aminopyridine for downbeat and upbeat nystagmus, memantine or gabapentin for pendular fixation nystagmus, or baclofen for periodic alternating nystagmus. "
02/01/2015 - "PHARMACOLOGICAL TREATMENT: Depending on the pathophysiology of different types of nystagmus, several drugs were effective in clinical application (off-label use): (i) gabapentin (non-selective GABAergic and anti-glutamatergic effect): up to 2400 mg/d in infantile nystagmus, acquired pendular nystagmus and oculopalatal tremor, (ii) nemantine (anti-glutamatergic effect): dosage up to 40 mg/d in infantile nystagmus, also in acquired pendular nystagmus and oculopalatal tremor, (iii) baclofen (GABA-B-receptor agonist): 3 × 5-10 mg/d in periodic alternating nystagmus and in upbeat nystagmus, (iv) 4-aminopyridine (non-selective blocker of voltage-gated potassium channels): 3 × 5 mg/d or 1-2 × 10 mg Fampridin in downbeat nystagmus and upbeat nystagmus, (v) acetazolamide (carbonic anhydrase inhibitor): in hereditary episodic ataxia type 2. OPTICAL DEVICES: (i) Contact lenses are used in infantile nystagmus in order to overcome negative effects of eye glasses in abnormal head posture, lateral gaze, and higher refractive errors, (ii) spectacle prisms are useful to induce an artificial exophoria (base-out prisms) or to shift an excentric null zone (base in direction of head posture) of infantile nystagmus with abnormal head posture, (iii) low vision aids may be necessary and should be prescribed according to magnification requirements."
5. Type A Botulinum Toxins (Botox)FDA Link
6. Botulinum Toxins (Botulinum Toxin)IBA
7. Clonazepam (Rivotril)FDA LinkGeneric
8. Valproic Acid (Depakote)FDA LinkGeneric
9. GABA-B Receptor AgonistsIBA
10. Voltage-Gated Potassium Channels (Voltage-Gated Potassium Channel)IBA

Therapies and Procedures

1. Therapeutics
2. Telescopes
02/01/2003 - "During monocular and binocular viewing, vertical OK stimulation induced vertical nystagmus in normal subjects, but all patients showed diagonal responses, with horizontal components that were significantly greater than controls. "
10/01/2023 - "To review the published literature assessing the clinical utility of genetic testing in individuals with infantile nystagmus syndrome (INS), defined as binocular conjugate nystagmus and onset prior to 6 months of age, with or without associated findings. "
01/01/2021 - "Two-dimensional binocular eye movement recordings were carried out on 5 adult subjects who exhibited a unilateral, uniplanar, vertical nystagmus secondary to a monocular late-onset severe visual loss in the oscillating eye (the Heimann-Bielschowsky Phenomenon). "
01/01/2019 - "We determined the effects of visual inputs on the nystagmus intensity and the effects of saccades on phase shift of the nystagmus in a patient with monocular pendular nystagmus from MS. In this patient, (1) during binocular viewing in the light, the nystagmus was observed only in the eye with more severe visual loss, (2) the nystagmus disappeared in darkness, (3) monocular viewing with either eye markedly suppressed the nystagmus, (4) the nystagmus decreased when the visual inputs became less asymmetric between the eyes, and (5) saccades resulted in a phase shift of the nystagmus. "
01/01/2019 - "Physical examination showed binocular deflection and horizontal nystagmus, but no abnormality was found on fundoscopy. "
3. Injections
4. Decompression
5. Operative Surgical Procedures