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Vertical and horizontal epileptic gaze deviation and nystagmus
1Department of Neurology, Francis Scott Key Medical Center, Baltimore, MD.
Neurology
|October 1, 1989
Summary
Epileptic nystagmus, characterized by alternating eye movements, correlated with specific brainwave patterns in a patient with a subdural hematoma. These findings link epileptic activity to eye movement control.
Area of Science:
- Neurology
- Neurophysiology
- Epileptology
Background:
- Epileptic seizures can manifest with diverse neurological signs.
- Understanding the relationship between cortical activity and eye movements is crucial for localizing seizure origins.
Observation:
- A comatose patient with a left hemisphere subdural hematoma exhibited periodic epileptic nystagmus.
- Nystagmus alternated between rightward/right-beating and upward/upbeating.
- Eye movements precisely correlated with specific electroencephalogram (EEG) patterns.
Findings:
- Upbeating nystagmus coincided with bifrontal spikes (3-4 Hz).
- Rightward eye deviation and right-beating nystagmus occurred with left hemispheric sharp waves (4-6 Hz).
- Absence of spike and wave activity meant no eye movements.
Implications:
- This case supports the concept of cortical control over saccadic eye movements.
- Correlating specific EEG patterns with nystagmus aids in understanding seizure localization.
- Provides insights into the neurophysiological basis of eye movement disorders during epilepsy.