Background: Acquired See-saw Nystagmus (SSN) is a rare
form of nystagmus characterized by elevation and intorsion of one eye with synchronous
depression and intorsion of the contralateral eye in the first half cycle, followed
by a reversal in the direction of the movements during the next half cycle. We herein
report a case of a 47-year-old woman with a 3-year history of constant diplopia
as a consequence of multiple neurosurgical interventions due to hemorrhage from
a cavernous angioma located in the subthalamic region. She also had a history of
major depressive disorder and ulcerative colitis. The patient underwent a surgical
intervention with a 5 mm bilateral recession of the superior and inferior rectus
muscles. Five years after surgery, the patient reported less recurrent and prominent
episodes of transient horizontal deviation with horizontal diplopia, with a prevalence
of well-being and comfort.
References
[1]
Maddox, E.E. (1913) See-Saw Nystagmus with Bitemporal Hemianopia. Proceedings of the Royal Society of Medicine, 7, 12-13.
Samkoff, L.M. and Smith, C.R. (1994) Seesaw Nystagmus in a Patient with Clinically Definite MS. European Neurology, 34, 228-229. https://doi.org/10.1159/000117044
[4]
Halmagyi, G.M., Aw, S.T., Dehaene, I., Curthoys, I.S. and Todd, M.J. (1994) Jerk-Waveform See-Saw Nystagmus Due to Unilateral Meso-Diencephalic Lesion. Brain, 117, 789-803. https://doi.org/10.1093/brain/117.4.789
[5]
Epstein, J.A., Moster, M.L. and Spiritos, M. (2001) Seesaw Nystagmus Following Whole Brain Intrathecal Methotrexate. Journal of Neuro-Ophthalmology, 21, 264-265. https://doi.org/10.1097/00041327-200112000-00007
[6]
Eggenberger, E. (2002) Delayed-Onset Seesaw Nystagmus Posttraumatic Brain Injury with Bitemporal Hemianopsia. Annals of the New York Academy of Sciences, 956, 588-591.
[7]
Dell’Osso, L.F., Hertle, R.W., Williams, R.W. and Jacobs, J.B. (1999) A New Surgery for Congenital Nystagmus: Effects of Tenotomy on an Achiasmatic Canine and the Role of Extraocular Proprioception. Journal of American Association for Pediatric Ophthalmology and Strabismus, 3, 166-182. https://doi.org/10.1016/S1091-8531(99)70063-7
[8]
Thurtell, M.J. and Brinkley, J.J. (2013) Treatment of Nystagmus and Saccadic Oscillations. http://eyerounds.org/tutorials/Nystagmus/
[9]
Thurtell, M.J., Joshi, A.C., Leone, A.C., Tomsak, R.L., Kosmorsky, G.S., Stahl, J.S. and Leigh, R.J. (2010) Crossover Trial of Gabapentin and Memantine as Treatment for Acquired Nystagmus. Annals of Neurology, 67, 676-680. https://doi.org/10.1002/ana.21991
[10]
Frisén, L. and Wikkelso, C. (1986) Posttraumatic Seesaw Nystagmus Abolished by Ethanol Ingestion. Neurology, 36, 841-844. https://doi.org/10.1212/WNL.36.6.841
[11]
Cochin, J.P., Hannequin, D., Domarcolino, C., Didier, T. and Augustin, P. (1995) Intermittent See-Saw Nystagmus Abolished by Clonazepam. Revue Neurologique (Paris), 151, 60-62.
[12]
Noorden, G.K. and Sprunger, D.T. (1991) Large Rectus Muscle Recessions for the Treatment of Congenital Nystagmus. Archives of ophthalmology, 109, 221-224. https://doi.org/10.1001/archopht.1991.01080020067045
[13]
Helveston, E.M., Ellis, F.D. and Plager, D.A. (1991) Large Recession of the Horizontal Recti for Treatment of Nystagmus. Ophthalmology, 98, 1302-1305. https://doi.org/10.1016/S0161-6420(91)32139-0
[14]
Dell’Osso, L.F. (2002) Development of New Treatments for Congenital Nystagmus. Annals of the New York Academy of Sciences, 956, 361-379. https://doi.org/10.1111/j.1749-6632.2002.tb02834.x
[15]
Dell’Osso, L.F., Orge, F.H., Jacobs, J.B. and Wang, Z.I. (2014) Fusion Maldevelopment (Latent/Manifest Latent) Nystagmus Syndrome: Effects of Four-Muscle Tenotomy and Re-Attachment. Journal of Pediatric Ophthalmology & Strabismus, 51, 180-188. https://doi.org/10.3928/01913913-20140326-01
