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Central nystagmus induced by deep-brain stimulation for epilepsy
R B Taylor1, R A Wennberg, A M Lozano
1Division of Neurology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Epilepsia
|December 13, 2000
Summary
Electrical deep-brain stimulation for epilepsy can cause central nystagmus. This study identified a specific brain region, the mesodiencephalic junction, responsible for this eye movement side effect.
Area of Science:
- Neuroscience
- Neurology
- Ophthalmology
Background:
- Deep-brain stimulation (DBS) is used to treat intractable epilepsy.
- Side effects of DBS can include nystagmus, an involuntary eye movement.
Observation:
- Bilateral DBS electrodes were implanted in the centromedian nucleus of the thalamus for epilepsy control.
- High-frequency stimulation of specific electrode contacts induced conjugate eye deviations and nystagmus.
Findings:
- The nystagmus-inducing electrode contacts were located at the mesodiencephalic junction, inferior to the centromedian nucleus and rostral to the superior colliculus.
- Stimulation induced ipsiversive slow-phase eye movements followed by contralateral fast phases, consistent with nystagmus.
- Electronystagmography confirmed constant velocity slow phases in the induced nystagmus.
Implications:
- This study localizes a central nystagmogenic area in humans.
- This area may be homologous to the nucleus of the optic tract in nonhuman primates, involved in optokinetic nystagmus.
- Understanding this nystagmogenic zone can help refine DBS targeting and minimize side effects.
