A 36-year-old woman complained of intermittent blurred vision and numbness and w

Question

A 36-year-old woman complained of intermittent blurred vision and numbness and weakness in her left leg that had persisted for longer than 3 weeks. On examination, vertical nystagmus (involuntary back and forth or circular movements of eyes) was noted on upward gaze. CSF was drawn and the specimen was clear and colorless with normal cell count. The CSF total protein level was 49 mg/dL with an IgG of 8.1 mg/dL. Electrophoresis of the patient's serum and CSF revealed the following pattern: more than 2 oligoclonal bands in CSF (shown here)

Explanation / Answer

There are two different types of nystagmus: pathological(caused due to congenital or idiopathic ) and physiological, with variations within each type. Nystagmus may be caused by congenital disorders, acquired or central nervous system disorders, toxicity, pharmaceutical drugs, alcohol, or rotational movement. Previously considered untreatable, in recent years several drugs like alcohol ledocaine CNS depressing drugs have been identified for treatment of nystagmus. Nystagmus is also occasionally associated with vertigo.

Early-onset nystagmus itself is usually mild and non-progressive. The affected persons are not normally aware of their spontaneous eye movements, but vision can be impaired depending on the severity of the movements.

Treatment .Baclofen, gabapentin,

Memantine, acetazolamide,aminopyridine,etc

In some cases surgery also preferred

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