See-saw Nystagmus Research Articles

See-saw Nystagmus Associated With Chiari Malformation

See-saw nystagmus has been seen with tumors of the parasellar region and diencephalon, brain-stem vascular lesions, syringobulbia, and after trauma. We report see-saw nystagmus in an adult with a Chiari malformation that was diagnosed by magnetic resonance imaging and confirmed intraoperatively. This patient's condition improved after surgical decompression. An association between see-saw nystagmus and Chiari malformation is potentially important because early diagnosis and decompression may improve neurologic function and prevent further deterioration.

Vertical nystagmus in infants with congenital ocular abnormalities.

In a series of 131 patients with congenital nystagmus, nine patients initially presented with vertical nystagmus associated with congenital ocular abnormalities. Four patients initially presented with upbeating nystagmus. All four of these patients had Leber's amaurosis. The upbeating nystagmus became horizontally directed in three of the four patients prior to one year of age. The other patient is now eight years old and upbeating nystagmus persists. CT scanning reveals cerebellar vermis hypoplasia in this patient. Five patients with albinism in this series presented initially with seesaw nystagmus. In two cases this resolved to one year of age, but in the other three cases, it is still intermittently seen in children ranging in age from two and a half to five years old. Vertically directed nystagmus may be associated with some ocular abnormalities in infancy and is not always a sign of isolated neurologic disorders.

See-saw jerk nystagmus

In the majority of cases see-saw nystagmus is of a pendular type. A case of transient see-saw jerk nystagmus is reported. The clinical diagnosis was brainstem infarction.

SEE-SAW NYSTAGMUS

SEE-SAW NYSTAGMUS

Ocular Oscillations

A variety of abnormal ocular oscillations consequent to brain stem and cerebellar dysfunction are described. The brain stem eye signs include: see-saw nystagmus, convergence-retraction nystagmus, down-beat nystagmus, ocular myoclonus, ocular bobbing, and superior oblique myokymia. The "cerebellar system" eye signs discussed are five varieties of nystagmus, square wave and macro square wave jerks, macro saccadic oscillations, ocular dysmetria and flutter, and opsoclonus.

Septo-optic dysplasia associated with see-saw nystagmus.

Septo-optic dysplasia is a syndrome of midline abnormalities of the central nervous system resulting in absence of the septum pellucidum and dysplasia of the optic chiasm or optic nerves. The characteristic fundus findings of small, dysplastic discs and defects in the nerve fiber layer enable the clinician to predict this syndrome prior to contrast studies. An unsual form of nystagmus, see-saw nystagmus, was associated with septo-optic dysplasia in this case report.

See-saw nystagmus: An unusual sign of brain-stem infarction

See-saw nystagmus is an unusual form of ocular involuntary movement which is not usually regarded as a sign of brain-stem ischaemia but has been more commonly associated with tumours in the region of the optic chiasm and diencephalon. The patient described in the present report demonstrated typical see-saw nystagmus in the acute phase after ponto-medullary infarction with associated skew deviation of the eyes and rotary nystagmus. The possible patho-physiological mechanisms involved in the production of see-saw nystagmus are discussed and the relationship between see-saw nystagmus and skew deviation is considered.

Stimulation and destruction of the region of the interstitial nucleus in cases of torticollis and see-saw nystagmus.

The interstitial nucleus of Cajal or the adjacent areas including the upper part of the medial longitudinal fasciculus was stimulated and finally destroyed in 12 cases of torticollis (mostly retrocollis) and one case of see-saw nystagmus. Stimulation of the above-mentioned area caused EMG discharges and contraction mostly of the posterior neck muscles in torticollis cases. It reproduced the see-saw nystagmus in one case of posttraumatic see-saw nystagmus. It may be stated that the interstital nucleus and the medial longitudinal fasciculus may play an important regulatory role in neck and eye movements.

See-Saw Nystagmus

See-Saw Nystagmus

SEESAW NYSTAGMUS. CASE REPORT ELUCIDATING THE MECHANISM.

Seesaw nystagmus is a very rare disturbance of ocular motility. The site of the responsible lesion has not been clearly identified, but a central lesion has been postulated in most previous reports. This case, the eighth noted in the literature,1-5is recorded as it offers a more probable explanation for this form of nystagmus. The original case report by Maddox1contains a superlative description of seesaw nystagmus. The eye movements in the patient described herein are identical to those described by Maddox and consists essentially of a disjunctive vertical pendular movement: One eye rises as the other falls. Simultaneous with the opposed rising and falling of the eyes, there occurs a conjugate parallel torsion. The rising of the right eye and the falling of the left eye are associated with a fine torsional movement to the left; the rising of the left eye and the falling of the

See-Saw Nystagmus

Since the first description of see-saw nystagmus in 1914 by Maddox 1 only seven cases have been reported in the literature. The phenomenon is rare but unmistakable; the eyes move vertically, symmetrically, and rhythmically in dissociated fashion, one looking up while the other looks down (hence the appellation "see-saw"). In addition, as the globe rises it intorts, and as it falls it extorts. When the gaze is directed upward, the movements tend to become faster but smaller. The sign is apparently not dependent upon reduction in visual acuity; however, nearly all patients have a bitemporal hemianopsia. Fixation on a near object or the presence of bright light (as from a flood lamp) diminishes or abolishes the sign. 2 Smith points out that the nystagmus is most easily observed by having the patient look down and then noting the lid movements. 3 The responsible lesion appears in most cases to be

Suprasellar epidermoid tumor. A case report with the presenting complaint of see-saw nystagmus.

Suprasellar epidermoid tumor. A case report with the presenting complaint of see-saw nystagmus.

See-Saw Nystagmus with Suprasellar Epidermoid Tumor

See-saw nystagmus is an extreme rarity, first reported by E. E. Maddox¹in 1914. In this phenomenon, the movements of the two eyes are pendular and dissociated, one rising while the other falls in opposite directions resembling a see-saw. Maddox' case was a 53-year-old man with a bitemporal hemianopia. We are aware of but one other reported case.²In the latter, see-saw nystagmus was noted in a patient with extremely low vision attributed to toxoplasma chorioretinitis. The following is the third reported case, and the first case of see-saw nystagmus with histologic verification. <h3>Report of a Case</h3> A 10-year-old white girl was first admitted to the Massachusetts General Hospital on Nov. 10, 1958. The chief complaint was "twitching eyes" of five months' duration. The girl had enjoyed excellent health until June, 1958, when one day a friend happened to notice that the patient's eyes were "twitching." Three months