Abstract
Pendular nystagmus often occurs in the setting of multiple sclerosis, but it can also occur in the syndrome of oculopalatal tremor. It has a sinusoidal waveform such that there are slow phases in both directions without corrective quick phases. Because it can cause disabling oscillopsia, many affected patients request treatment. In this chapter, we begin by reviewing the clinical features and pathogenesis of pendular nystagmus occurring in the setting of multiple sclerosis. We next review the clinical features and pathogenesis of oculopalatal tremor, which is most commonly a delayed consequence of brainstem tegmentum or cerebellar stroke. Lastly, we review the medical treatment options for pendular nystagmus, which include gabapentin and memantine.
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