Abstract
Epileptic nystagmus (EN) describes repetitive eye movements that result from seizure
activity. We describe a patient with EN and vertigo first noted at the age of 4 yr and 10 mo. Brain MRI did not show anomalies. Ictal EEG recordings revealed epileptic activity
during three episodes of horizontal, left-beating nystagmus not crossing the midline.
Ictal 99mTc-ECD SPECT demonstrated the presence of active foci in multiple cerebral regions
including bilateral prefrontal, bilateral parieto-temporo-occipital and the left parieto-insular-vestibular
areas. A wide area of hypoperfusion was also evident in the right hemisphere, prevailing
in the parieto-occipital regions and the medial prefrontal gyrus. Topiramate was started
at a dose of 2 mg/kg/d with complete seizure control after 14 d. EEG and SPECT were repeated after a seizure-free period of 1 mo; disappearance of epileptic activity and modification of cerebral perfusion were
evident. This case reaffirms the cortical origin and involvement of temporo-occipital
and frontal cortex in the genesis of saccadic epileptic nystagmus. Rapid complete
control of clinical events coincided with the normalization of EEG and improvement
of the SPECT pattern.
Keywords
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References
- Neurophysiologic and clinical correlations of epileptic nystagmus.Neurology. 1993; 43: 2508-2514
- Epileptic nystagmus in a patient with nonconvulsive status epilepticus.Seizure. 2004; 13: 183-186
- Epileptic nystagmus: two case reports, clinical and pathophysiological review of the literature.J Neurol. 2006; 253: 767-771
- Epileptic nystagmus in infancy.J Neurol Sci. 1997; 151: 111-114
- Neurologic nystagmus in childhood: anatomo-clinic correlations.Italian J Ped. 1997; 23: 381-388
- Epileptic nystagmus.Epileptic Disord. 2006; 8: 305-308
- Epileptic nystagmus.Neurology. 2004; 63: E14
- Lateralizing value of epileptic nystagmus.Epilepsy Behav. 2008; 13: 700-702
- Saccadic eye movements and anti-epileptic drugs.Epilepsy Res. 2008; 78: 93-101
- Eye movement control by the cerebral cortex.Curr Opin Neurol. 2004; 17: 17-25
- Brain SPECT evaluation of patients with pure photosensitive epilepsy.J Nucl Med. 1996; 37: 1755-1759
Article info
Publication history
Published online: September 14, 2010
Accepted:
August 18,
2010
Received in revised form:
August 16,
2010
Received:
March 16,
2010
Identification
Copyright
© 2010 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
