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The Heimann-Bielschowsky phenomenon after optic neuritis.

E Anagnostou¹, D Karathanasis¹, M E Evangelopoulos¹

¹Department of Neurology, University of Athens, Eginition Hospital, Athens, Greece.

Multiple Sclerosis and Related Disorders

|January 18, 2022

Summary

A rare Heimann-Bielschowsky phenomenon (HBP) caused spontaneous vertical eye movements in a multiple sclerosis patient. This neuro-ophthalmologic finding, while unusual, is benign and linked to optic nerve and brainstem network disruptions.

Keywords:

Heimann-Bielschowsky phenomenon Pendular nystagmus dissociated nystagmus eye movements optic neuritis

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Area of Science:

Neuroscience
Ophthalmology
Neurology

Background:

Multiple sclerosis (MS) can cause various neuro-ophthalmologic manifestations.
Optic neuritis is a common MS complication, sometimes leading to incomplete recovery.
The Heimann-Bielschowsky phenomenon (HBP) is a rare form of dissociated nystagmus.

Observation:

A 32-year-old woman with relapsing-remitting MS and optic neuritis presented with a unique vertical nystagmus.
This spontaneous, pendular, vertical eye movement was diagnosed as the Heimann-Bielschowsky phenomenon (HBP).

Findings:

The Heimann-Bielschowsky phenomenon (HBP) in this case likely results from a dual abnormality mechanism.
This mechanism involves asymmetric conduction delay in the optic nerve and disrupted brainstem gaze pathways.

Implications:

Recognizing this rare neuro-ophthalmologic syndrome is crucial for clinicians.
The Heimann-Bielschowsky phenomenon (HBP) associated with MS is considered benign, aiding in patient management.