Treatment Of Congenital Nystagmus Research Articles

Application of horizontal rectus muscle suture clamp for the treatment of congenital nystagmus without intermediate band

Objective To evaluate the efficacy of application of horizontal rectus muscle suture clamp for the treatment of congenital nystagmus (CN) without intermediate band. Methods The data of 11 patients with no intermediate band CN from Jan.2016 to Jun.2017 were retrospectively analyzed. All cases received the self designed surgery of horizontal rectus muscle suture clamp. The visual acuity(LogMAR), the amplitude and frequency of nystagmus before and after operation were summarized. Results The best corrected visual acuity of right eye before and 1, 3 months after operation were 0.65±0.25, 0.42±0.26 and 0.38±0.23, respectively. Those of left eye were 0.62±0.26, 0.38±0.17 and 0.35±0.14, respectively. The postoperative best corrected visual acuity at 1 and 3 months of binocular were improved (P<0.05). The amplitude and frequency of nystagmus at 3 months after operation were decreased. The difference was statistically significant between before and after operation (P<0.05). Conclusion Horizontal rectus muscle suture clamp for the treatment of CN without intermediate band can effectively decrease amplitude and frequency of nystagmus, and significantly improve visual function. Key words: Nystagmus, congenital, without intermediate band; Suture, clamp

Diagnosis and treatment of congenital nystagmus

Diagnosis and treatment of congenital nystagmus

Memantine and gabapentin are useful in the treatment of congenital nystagmus

Memantine and gabapentin are useful in the treatment of congenital nystagmus

Surgical Treatment of Congenital Nystagmus with Anomalous Head Posture (AHP): Kestenbaum–Anderson with Faden Operation

Surgical Treatment of Congenital Nystagmus with Anomalous Head Posture (AHP): Kestenbaum–Anderson with Faden Operation

Clinical observation of tendotomy for the treatment of congenital nystagmus

目的 探讨治疗先天性眼球震颤的简捷、有效的手术方法.方法对21例年龄在7～12岁的先天性眼球震颤患者,采用改良的Parks手术方法,即在Parks手术方法的基础上采用直肌边切术代替Parks法中的直肌后退,而Parks法中的直肌缩短仍保持不变.结果15例(71.43%)患者相对静止眼位移至正前方,正前方眼震基本消失,6例(28.57%)眼震明显减轻,正前方为低幅低频震颤,视力提高2～5行;18例(85.71%)代偿头位基本消失,3例(14.29%)明显改善.16例术后随访2年,其中8例术后有轻度回退现象,6周后稳定者7例,经过2年随访,情况稳定者15例.经1～2年随访,18例效果满意.结论该术式效果肯定,手术操作简捷.手术因不需缝合巩膜,故不会有发生巩膜穿孔的危险,提高了手术的安全性。

Surgical management of anomalous head posture because of horizontal gaze palsy or acquired vertical nystagmus.

To confirm the effectiveness of the Kestenbaum-Anderson principle in the surgical management of compensatory head posture because of horizontal gaze palsy and acquired vertical nystagmus. Nine patients with anomalous head posture because of horizontal gaze palsy, and four patients with acquired vertical nystagmus and oscillopsia and compensatory torticollis underwent surgery according to the Kestenbaum-Anderson principle. As in the treatment of congenital nystagmus, the eyes have to be shifted in the orbits, in the direction of anomalous head posture. Homonymously based prisms were used preoperatively to assess the potential benefit of surgery. At the time of surgery, the clinical conditions of the patients had been stable for at least 1 year. After surgery, compensatory head posture and visual performances improved in all cases and the results remained stable for at least 2 years. Contrary to what is generally believed, the ocular condition of the patients with compensatory head posture secondary to neurological causes can be often improved with surgery. The aim of surgery is obviously not to modify ocular motility, but rather to improve the head position.

Nystagmus.

Electronystagmographic studies with an attempt to quantify various parameters of congenital nystagmus are interesting although not conclusive clinically. This is due to the spontaneous variability of congenital nystagmus. A qualitative study (position and velocity) may be sufficient for clinical examination and treatment of congenital nystagmus. The quantification of the optokinetic response is also clinically difficult. This comes from the fact that various factors can affect the response; even healthy patients can have variable gain. However the optokinetic test, which compares the response to a nasotemporal and temporonasal stimulation, is useful. It enables us to identify patients who never had a visual binocular experience in their first year of life and who keep a directional asymmetry of the monocular optokinetic response.

The treatment of congenital nystagmus with Botox.

Clostridium botulinum A exotoxin (Botox) is the most potent toxin known to man. It produces a reversible paralysis of cholinergically innervated muscle, an effect useful in the management of non-accommodative strabismus and various disabling focal dystonias. In the present study, botulinum toxin (Botox) was used to treat congenital nystagmus, injecting the toxin into multiple horizontal rectus muscles at the same treatment session. Three of four patients achieved a significant enough change in acuity to receive daytime-restricted driver's licenses. No treatment was complicated by retrobulbar hemorrhage, ocular perforation, or ptosis. Two patients are continuing the Botox treatments every 3 to 4 months.

Computer analysis of ENG spectral features from patients with congenital nystagmus

Power spectral estimation from electronystagmographic recording of eye position is proposed as a simple digital processing method to quantify both the amplitude and the frequency features of eye motion in patients affected by the oculomotor disorder of congenital nystagmus (CN). Different basic wave shapes clinically identified and studied in the literature are shown to have slightly different power spectra, which can be used to characterize the CN disorder from nystagmus waveforms. This treatment, statistical in nature, does not depend strongly on the detailed structure of each recorded wave shape, thus emphasizing that accurate descriptive analysis of all patient's waveforms characteristics adds little to the comprehension of CN. We show that the power spectral estimation also represents a useful tool in modelling both the CN defect and the non-defective oculomotor system, and in assessing the effect of the surgical treatment of CN through the differences in the power spectra before and after surgery.

先天性眼振に関する臨床的研究 第一報 治療への試み（２％キシロカイン１〜３ｍｌ＋２０％ブドウ糖液２０ｍｌの静注）

先天性眼振に関する臨床的研究 第一報 治療への試み（２％キシロカイン１〜３ｍｌ＋２０％ブドウ糖液２０ｍｌの静注）

Recent Development of the Study on Clinical Significance of Abnormal Eye Movement

As a general trend, the diagnosis in medical clinics often depends on laboratory test results. Neurotological diagnosis, however, requires detailed neurological examinations on a patient by a neurotologist. Therefore, there are differing diagnostic skills among physicians, and there is a kind of "man-made flavor" in neurotological diagnostic procedure. In the present study, current development in the knowledge on the clinical diagnostic significance of pathological eye movement during the last 2-3 years is summarized. Acquired pendular wondering eye-movement. Fixation jerks. Spontaneous and transitory eyeball burst or seizure. Vertical rebound nystagmus. Optokinetic vertical ocular dysmetria. Divergence nystagmus. Counterolling, pure rotatory positioning nystagmus. Inversion of optokinetic after-nystagmus (OKAN). Vertical congenital nystagmus and inversion of optokinetic nystagmus (OKN). Treatment of congenital nystagmus. Vertical spontaneous nystagmus to lower eyelid or so-called "downbeat nystagmus." Downbeat nystagmus seen in bilateral labyrinthine dysfunction. The significance of bilateral vestibular lesion, or symmetric lesion in other is emphasized in the present report for reader's reference and criticism. Our experience on the clinical significance of the abnormal eye movement was reported. It is our wish that accumulation of data on important cases along with the results of experimental studies directly connected with clinical medicine may contribute to the progress of our neurotology in the right direction as "neurology of the posterior fossa."

Auditory feedback in the control of congenital nystagmus.

The control of oscillatory eye movements in congenital nystagmus was studied in five human subjects. Auditory feedback of eye position and eye motion was given to each subject to aid in controlling the abnormal eye movement. Less than one hour was needed for all the subjects to learn to use the auditory information. Reductions in eye movement amplitude ranged from 41 to 73%. Sensory functions like visual acuity and contrast sensitivity also improved under the auditory feedback condition. Auditory feedback of eye position is thought to have potential usefulness in the treatment of congenital nystagmus.