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Acquired convergence-evoked pendular nystagmus in multiple sclerosis
J J Barton1, T A Cox, K B Digre
1Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Summary
Acquired convergence-evoked pendular nystagmus is an unusual finding, particularly in multiple sclerosis (MS) patients. This study highlights four MS cases with this specific nystagmus, suggesting it may be more common than previously thought.
Area of Science:
- Ophthalmology
- Neuroscience
- Neurology
Background:
- Convergence-evoked pendular nystagmus is a rare condition.
- Multiple sclerosis (MS) can present with diverse neurological symptoms, including ocular motor disturbances.
Observation:
- Four patients with multiple sclerosis (MS) presented with acquired convergence-evoked pendular nystagmus.
- The nystagmus was horizontal, asymmetric, and conjugate in its phase between the eyes.
- Patients also exhibited optic neuropathy and cerebellar dysfunction.
Findings:
- Eye movement recordings revealed a conjugate, not divergent-convergent, relationship in nystagmus.
- Covering one eye during near fixation reduced nystagmus and caused divergent drift of the covered eye.
- Scopolamine administration transiently reduced nystagmus in one patient.
- Base-in prisms improved symptoms of oscillopsia and reading acuity.
Implications:
- Convergence-evoked pendular nystagmus may be an underrecognized sign in multiple sclerosis.
- Understanding this specific nystagmus can aid in diagnosing and managing MS patients.
- Further research is warranted to explore the prevalence and underlying mechanisms of this condition in MS.