Nystagmus

In unilateral medial longitudinal fasciculus lesions the eye fails to adduct towards the affected side.

N.B. Internuclear ophthalmoplegia differs from a bilateral III nerve or nuclear lesion in that the pupil is not affected and when testing eye movements individually, some adduction occurs.

The disorder characteristically occurs in multiple sclerosis but also in brainstem infarction, haemorrhage, trauma, syringobulbia and drug toxicity (phenytoin).

OTHER VARIETIES OF CENTRAL NERVOUS SYSTEM NYSTAGMUS

OTHER VARIETIES OF CENTRAL NERVOUS SYSTEM NYSTAGMUS

A group of confusing terms are used to describe abnormal, involuntary eye movements seen in cerebellar/brain stem disease:

Ocular bobbing - fast drift downwards, slow drift upwards; seen with large pontine lesions. (Horizontal eye movements are absent.)

Opsoclonus - rapid conjugate jerks of eyes; made worse by head movement. The eye movements are random. Oscillopsia is a term used to describe the patient's awareness of jumping of the environment as a consequence of rapid jerking eye movements.

A group of confusing terms are used to describe abnormal, involuntary eye movements seen in cerebellar/brain stem disease:

Ocular bobbing - fast drift downwards, slow drift upwards; seen with large pontine lesions. (Horizontal eye movements are absent.)

Opsoclonus - rapid conjugate jerks of eyes; made worse by head movement. The eye movements are random. Oscillopsia is a term used to describe the patient's awareness of jumping of the environment as a consequence of rapid jerking eye movements.

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