Epileptic nystagmus

Furman, Joseph M.; Crumrine, Patricia K.; Reinmuth, Oscar M.

doi:10.1002/ana.410270617

Cited by 24 publications

(20 citation statements)

References 11 publications

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“…In the 2 patients in whom the eye version took the form of ictal nystagmus, the fast phase of the eye movement was contralateral to the side of seizure onset, with a slow eye movement back towards the midline. This is consistent with previous findings in adults and older children [8], and isolated cases reported in infancy [12]. Sustained tonic eye deviation was seen both ipsilateral and contralateral to the side of seizure onset, and did not appear to be a reliable lateralizing sign in this age group.…”

Section: Discussionsupporting

confidence: 93%

Lateralizing signs during seizures in infants

et al. 2004

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Reliable lateralizing signs included focal clonic activity and predominantly unilateral spasms. Focal tonic activity, nystagmus and postictal hemiparesis were also consistently contralateral but were observed only in few patients. Tonic eye version was unreliable and could not be used to lateralize seizure onset. The sequence of eye and head version evolving to generalized tonic clonic convulsions was not seen in this age group.

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Section: Discussionsupporting

confidence: 93%

Lateralizing signs during seizures in infants

et al. 2004

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“…Activation of these regions induces nystagmus with the fast phase beating opposite to the side of the epileptic focus. This is followed by an ipsilateral centripetal slow drift of the eyes that do not cross the midline (8,13). Second, EN may be caused by epileptic discharges in the tempero-parieto-occipital junction.…”

Section: Case Reportmentioning

confidence: 98%

“…First described at 1954 with corresponding electroencephalography (EEG) (5), EN has been observed in 10% of 42 cases with occipital lobe epilepsy (6) and described as a lateralizing sign of focal epilepsy in adults and in children (7). The epileptic focus of EN is located in the cortical areas of the brain controlling conjugated saccadic eye movements (1,(8)(9)(10)(11). In previous reports, the direction of the fast component of EN was contralateral to the seizure focus.…”

mentioning

confidence: 95%

Nonconvulsive Status Epilepticus Presenting as Epileptic Nystagmus in a Patient With Herpes Encephalitis

Nam

Shin

et al. 2012

Journal of Neuro-Ophthalmology

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“…Whether a high frequency of attacks per day (as seen in some patients with vestibular paroxysmia) 40 excludes i-EVD is unknown; the reports we reviewed described patients with daily or more frequent spells in only 2 cases. 10,41 Patients with suspected vestibular paroxysmia should probably be assessed by EEG to exclude the possibility of i-EVD as an alternative cause for brief paroxysms before treatment with carbamazepine.…”

Section: Pulmonarymentioning

confidence: 99%

Clinical and electrographic findings in epileptic vertigo and dizziness

et al. 2015

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Objective: Seizures can cause vestibular symptoms, even without obvious epileptic features. We sought to characterize epileptic vertigo or dizziness (EVD) to improve differentiation from nonepileptic causes, particularly when vestibular symptoms are the sole manifestation. Methods:We conducted a systematic review with electronic (Medline) and manual search for English-language studies . Two independent reviewers selected studies. Study/patient characteristics were abstracted. We defined 3 study population types: (1) seizures, some experiencing vertigo/dizziness (disease cohort); (2) vertigo/dizziness, some due to seizures (symptom cohort); (3) vertigo/dizziness due to seizures in all patients (EVD-only cohort). Results:We identified 84 studies describing 11,354 patients (disease cohort 5 8,129; symptom cohort 5 2,965; EVD-only cohort 5 260). Among 1,055 EVD patients in whom a distinction could be made, non-isolated EVD was present in 8.5%, isolated EVD in 0.8%. Thorough diagnostic workups (ictal EEG, vestibular testing, and brain MRI to exclude other causes) were rare (,0.1%). Ictal EEG was reported in 487 (4.3%), formal neuro-otologic assessment in 1,107 (9.7%). Localized EEG abnormalities (n 5 350) were most frequently temporal (79.8%) and uncommonly parietal (11.8%). Duration of episodic vestibular symptoms varied, but was very brief (,30 seconds) in 69.6% of isolated EVD and 6.9% of non-isolated EVD.Conclusions: Non-isolated EVD is much more prevalent than isolated EVD, which appears to be rare.Diagnostic evaluations for EVD are often incomplete. EVD is primarily associated with temporal lobe seizures; whether this reflects greater epidemiologic prevalence of temporal lobe seizures or a tighter association with dizziness/vertigo presentations than with other brain regions remains unknown. Consistent with clinical wisdom, isolated EVD spells often last just seconds, although many patients experience longer spells. Neurology ® 2015;84:1595-1604 GLOSSARY AED 5 antiepileptic drug; EVD 5 epileptic vertigo or dizziness; i-EVD 5 isolated epileptic vertigo or dizziness; ni-EVD 5 nonisolated epileptic vertigo or dizziness.

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Epileptic nystagmus

Cited by 24 publications

References 11 publications

Lateralizing signs during seizures in infants

Lateralizing signs during seizures in infants

Nonconvulsive Status Epilepticus Presenting as Epileptic Nystagmus in a Patient With Herpes Encephalitis

Clinical and electrographic findings in epileptic vertigo and dizziness

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