This chapter reviews the approach to the patient with nystagmus or
saccadic intrusions and their clinical features (with illustrative
video cases), etiology, pathophysiology, and management. Nystagmus
caused by peripheral vestibular disorders; downbeat, upbeat, and
torsional nystagmus; periodic alternating nystagmus, seesaw and
hemi-seesaw nystagmus; gaze-evoked nystagmus; Bruns nystagmus;
centripetal and rebound nystagmus; nystagmus occurring in association
with disease of the visual system; acquired pendular nystagmus with
multiple sclerosis; oculopalatal tremor; convergence-retraction
nystagmus; infantile nystagmus syndrome; fusional maldevelopment
nystagmus syndrome and latent nystagmus; spasmus nutans syndrome; and
lid nystagmus are discussed. Saccadic intrusions and oscillations and
the clinical features, etiology, pathophysiology, and management of
square-wave jerks, macrosaccadic oscillations, saccadic pulses, ocular
flutter, opsoclonus, and voluntary saccadic oscillations are
summarized. Treatments for nystagmus and saccadic intrusions are
summarized, including pharmacological treatments, optical treatments,
procedures to weaken the extraocular muscles (e.g.,
Kestenbaum-Anderson procedure), and measures such as biofeedback and
vibration.
Unilateral vertical pendular nystagmus in multiple sclerosis: A distinctive neuro-ophthalmological sign
