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Epileptic skew deviation

C A Galimberti1, M Versino, I Sartori

  • 1Epilepsy Centre, Neurological Institute C. Mondino Foundation, Pavia, Italy.

Neurology
|May 22, 1998
PubMed
Summary
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Epileptic seizures can cause temporary vision problems like double vision (diplopia) and eye movement issues (oscillopsia). This case links these symptoms to specific brain activity in the vestibular cortex.

Area of Science:

  • Neuroscience
  • Ophthalmology
  • Neurology

Background:

  • Epileptic seizures can manifest with diverse neurological symptoms.
  • Ocular motor disturbances are sometimes associated with focal epileptic discharges.

Observation:

  • A 43-year-old patient experienced transient diplopia and oscillopsia.
  • These visual symptoms correlated with a right-beating nystagmus and skew deviation.
  • The ocular motor signs were linked to left posterior electroencephalogram (EEG) epileptic discharges.

Findings:

  • The study proposes that ictal activation of the vestibular cortex triggered the observed ocular motor signs.
  • This activation led to downstream effects on vestibular nuclei.
  • The proposed mechanism explains both dynamic (nystagmus) and static (skew deviation) vestibular imbalances during the seizure.

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Implications:

  • This case highlights a potential ictal manifestation of vestibular cortex involvement.
  • Understanding this link can aid in diagnosing and managing complex seizure presentations.
  • It underscores the intricate relationship between cortical activity and ocular motor control.