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Epileptic monocular nystagmus and ictal diplopia as cortical and subcortical dysfunction
Reinhard Schulz1, Maria Tomka-Hoffmeister1, Friedrich G Woermann2
1Epilepsie-Zentrum Bethel, Krankenhaus Mara, Maraweg 21, D-33617 Bielefeld, Germany.
Abstract:
We present the case of a patient with ictal monocular nystagmus and ictal diplopia who became seizure-free after resection of a right frontal focal cortical dysplasia (FCD), type 2B. Interictal neuroophthalmological examination showed several beats of a monocular nystagmus and a spasm of the contralateral eye. An exclusively ictal monocular epileptic nystagmus could be an argument for an exclusively cortical involvement in monocular eye movement control. The interictal findings in our patient, however, argue for an irregular ictal activation of both the cortical frontal eye field and the brainstem.
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