Cortical Blindness Following Ictal Nystagmus

Epileptic Nystagmus

“…In both our patients, the fast phase of the EN was directed toward the side opposite the seizure discharge, as in 23 of 32 earlier persons in whom the direction of nystagmus was specified and ictal EEGs were obtained (Terzian, 1955;Infuso and Migliore, 1959;Gastaut, 1960;Giove, 1960;Caneschi et al, 1963;Ricci and Vizioli, 1966;Arend et al, 1968;Rad, 1970;White, 1971;Huott et al, 1974;Enokido et al, 1977;Hidaka et al, 1978;Smith and Docherty, 1982;Beun et al, 1984;Barry et al, 1985;Ramani, 1985;Thurston et al, 1985;Barry, 1986;Aldrich et al, 1989;Furman et al, 1990;Tusa et al, 1990). The remaining 9 individuals had EN which was ipsiversive in 2 (Gastaut and Roger, 1954;Gastaut, 1960), pendular in 3 (Trevisan and Belsasso, 1961;Trevisan and Dettori, 1967;Kanazawa et al, 1989), upbeat in 2 (Shanzer et al, 1965;Pritchard and Tucker, 1982), alternately contraversive and vertical in 1 (Kaplan and Lesser, 1989), and "poorly systematized" in 1 (Talairach et al, 1961).…”

“…With conventional electrode placement, the EEG paroxysms involved the occipital, posterotemporal, and parietal areas of the scalp. This finding is in agreement with observations made in the majority (26 of 33) of reported cases of EN in which ictal EEGs were recorded (Gastaut and Roger, 1954;Terzian, 1955;Infuso and Migliore, 1959;Gastaut, 1960;Giove, 1960;Talairach et al, 1961;Caneschi et al, 1963;Ricci and Vizioli, 1966;Arend et al, 1968;Rad, 1970;White, 1971;Huott et al, 1974;Enokido et al, 1977;Hidaka et al, 1978;Goldberg and Adelman, 1980;Beun et al, 1984;Barry et al, 1985;Ramani, 1985;Thurston et al, 1985;Aldrich et al, 1989;Kanazawa et al, 1989;Furman et al, 1990;Tusa et al, 1990). Supplementary scalp electrodes further localized the seizures to electrodes situated between 02 and T6 in our first patient and between 02, T6 and P4 in a patient studied by Tusa et al (1990).…”

“…Eleven other patients with EN studied by other investigators were reported to be similarly neurologically intact interictally (Gastaut and Roger, 1954;Gastaut, 1960;Talairach et al, 1961;Rad, 1970;White, 1971;Enokido et al, 1977;Hidaka et al, 1978;Smith and Docherty, 1982;Beun et al, 1984;Furman et al, 1990). Among the remaining individuals, disorders varied from strokes (Barry et al, 1985;Ramani, 1985;Kanazawa et al, 1989), subdural hematomas (Kaplan and Lesser, 1989), and tumors (Terzian, 1955;Trevisan and Dettori, 1967) to dialysis dementia (Pritchard and Tucker, 1982) and hyperglycemic coma (Thurston et al, 1985;Lavin, 1986). EN as an expression of focal seizures may thus occur either with or without an identifiable etiology.…”

“…Key Words: Eye manifestations-Nystagmus-Focal epilepsy-Stimulus-sensitive epilepsy-Epileptic nystagmus-Ictal nystagmus-Oculoclonic seizures. al., 1977; Hidaka et al, 1978;Goldberg and Adelman, 1980;Pritchard and Tucker, 1982;Smith and Docherty, 1982;Beun et al, 1984; Barry et al, 1985;Ramani, 1985; Thurston et al, 1985;Barry, 1986;Lavin, 1986;Aldrich et al, 1989;Kanazawa et al, 1989; Kaplan and Lesser, 1989;Furman et al, 1990;Tusa et al, 1990). In reviewing the literature on EN since the inception of EEG, we excluded from consideration cases with incomplete clinical or EEG data (Gastaut and Roger, 1954;Bickford and Klass, 1965; Oikawa et al, 1977), nystagmus of uncertain epileptic nature (Paolozzi et al, 1970) or EEG epileptic activity other than clearly individualized partial seizures.…”