Epileptic nystagmus in infancy.
Epileptic nystagmus (EN) is a rare form of nystagmus that occurs only during epileptic seizures. We report an infantile case in which EN was first noted at 10 days of age. Electronystagmography showed a right-beating nystagmus with predominantly linear slow phases that traversed the midline. Neuro-imaging revealed dysplasia of the left middle temporal gyrus extending posteriorly into the parieto-occipital cortex. The right hemisphere and subcortical structures appeared normal. Perfusion studies demonstrated interictal hypoperfusion with ictal hyperperfusion in the left temporal lobe. Electrocorticography demonstrated spiking over the left temporal-parieto-occipital region. Following extensive surgical resection of this area and weaning of anti-convulsants, the child has remained seizure-free without nystagmus. This case demonstrates the cortical origin of EN, and shows that infant cortex has functioning efferent connections to brainstem oculomotor centres from 10 days of age.
Harris
C M
CM
Great Ormond Street Hospital for Children, NHS Trust and Institute of Child Health, University College London, UK.
Boyd
S
S
Chong
K
K
Harkness
W
W
Neville
B G
BG
D004569:Electroencephalography; D004584:Electronystagmography; D004827:Epilepsy / Q000150:complications*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D009759:Nystagmus, Pathologic / Q000209:etiology*; D011698:Pursuit, Smooth