Related Experiment Videos
Periodic complexes and alternating rotatory nystagmus with cyclic pupillary changes
1Department of Medicine, Palmetto General Hospital, Hialeah, Florida 33016.
Clinical EEG (Electroencephalography)
|October 1, 1989
Summary
Periodic lateralized epileptiform discharges (PLEDs) on EEG can manifest as subtle neuro-ophthalmologic signs in comatose patients. These complex eye movement abnormalities may indicate underlying brain dysfunction with prognostic significance.
Area of Science:
- Neuroscience
- Ophthalmology
- Clinical Neurology
Background:
- A 69-year-old male with a history of subdural hematoma, dementia, and hydrocephalus presented with coma.
- Previous medical history included multistroke dementia and ventricular shunting for hydrocephalus.
Observation:
- The patient exhibited isolated periodic alternating rotatory nystagmus with cyclic pupillary changes and periodic alternating gaze.
- Electroencephalography (EEG) revealed periodic lateralized epileptiform discharges (PLEDs) and later a burst-suppression pattern.
Findings:
- The burst-suppression pattern on EEG correlated with transient eyelid opening synchronized with EEG bursts.
- Complex neuro-ophthalmologic signs can be the primary presentation of EEG periodic complexes.
Implications:
- Subtle neuro-ophthalmologic findings may indicate significant EEG abnormalities.
- Recognition of these signs is crucial for understanding prognostic and therapeutic implications in comatose patients.
- Highlights the link between EEG patterns and complex ocular motor disturbances.