Nystagmus

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Introduction

What is nystagmus?

Nystagmus is an involuntary condition in which the eyes make rapid, repeated, uncontrolled movements. These eye movements may be in any direction including horizontally, vertically, or rotationally (in a circle). Many people with nystagmus do not experience visual symptoms. At other times, nystagmus leads to visual problems because the eye cannot maintain steady focus on an object. Children with extremely poor vision may develop nystagmus.

Although the exact cause of nystagmus is not known, it is thought to be related to a disorder in the part of the brain that controls eye movement. Nystagmus may be present at birth (congenital nystagmus) and is often inherited or caused by development problems in the visual system. Another variation of nystagmus, called spasmus nutans, usually appears by the age of six months and goes away by itself in early childhood.

Nystagmus can also develop at any other point in life, usually as a result of head trauma, stroke, or certain drugs and medications. This type of nystagmus is called acquired nystagmus.

In association with uncontrolled eye movements, patients with nystagmus may experience problems with depth perception. The loss of visual acuity and depth perception can also lead to coordination problems. While the exact cause of nystagmus is not well understood, fatigue or increased levels of stress appear to worsen the condition.

Congenital or inherited nystagmus is not typically associated with serious medical conditions. However, acquired nystagmus may be a sign of a serious medical condition, including severe head trauma, toxicity, stroke, or inflammatory diseases or other conditions that affect the brain. Seek immediate medical care (call 911) if you, or someone you are with, has a sudden onset of nystagmus.

If you have already been diagnosed with nystagmus and it is causing you concern, seek prompt medical care.

Symptoms

What other symptoms might occur with nystagmus?

Nystagmus may accompany other symptoms, which vary depending on the underlying disease, disorder or condition that causes the nystagmus.

Symptoms that may occur along with congenital nystagmus or spasmus nutans

Congenital nystagmus may accompany other symptoms affecting the head, eyes or vision including:

  • Absence of the iris
  • Cataracts
  • Head nodding
  • Incomplete development of the optic nerve
  • Lack of pigmentation in the skin and eyes (albinism)

Symptoms that may occur along with acquired nystagmus

Acquired nystagmus may accompany other symptoms affecting the head, eyes or vision including:

  • Abnormal blinking
  • Head nodding
  • Headache
  • Loss of muscle coordination
  • Loss of visual acuity
  • Strabismus (crooked eyes)

Serious symptoms that might indicate a life-threatening condition

In some cases, acquired nystagmus may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

Causes

What causes nystagmus?

Nystagmus may be hereditary or caused by developmental problems in the part of the brain that controls eye motion. These types of nystagmus are called congenital nystagmus or spasmus nutans. Acquired nystagmus, which can occur at any age, may be caused by trauma, underlying medical conditions or diseases, or drugs. These underlying conditions or diseases may be serious.

Common causes of acquired nystagmus

Acquired nystagmus may be caused by relatively common underlying medical conditions or certain lifestyle factors including:

  • Alcohol intoxication

  • Medical disorders involving the inner ear such as labyrinthitis (Meniere’s disease)

  • Multiple sclerosis (disease that affects the brain and spinal cord causing weakness, coordination and balance difficulties, and other problems)

  • Parkinson’s disease (brain disorder that impairs movement and coordination)

  • Sedative medications

Serious or life-threatening causes of nystagmus

In some cases, acquired nystagmus may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Brain tumor
  • Drug overdose or toxicity
  • Head trauma
  • Stroke

Questions for diagnosing the cause of nystagmus

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your nystagmus including:

  • When did you, or someone else, first notice your nystagmus?
  • How much alcohol do you drink?
  • Are you experiencing changes in your vision? If so, what changes?
  • Do you have a family history of nystagmus?
  • Do you have any other medical conditions?
  • Have you had a head injury?
  • Have you recently had any cognitive dysfunction?
  • What medications are you taking?

What are the potential complications of nystagmus?

The complications of nystagmus itself include reduced visual acuity and impaired coordination. However, acquired nystagmus may be a sign of a serious underlying medical condition or disease, such as head trauma, stroke, or drug toxicity, and failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Adverse effects of treatment for nystagmus
  • Brain damage
  • Difficulty walking and maintaining balance
  • Loss of cognitive abilities
  • Paralysis
  • Permanent disability
  • Unconsciousness and coma
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 26
  1. Nystagmus. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003037.htm.
  2. Nystagmus. American Optometric Association. http://www.aoa.org/x9763.xml.
  3. Tierney LM Jr., Saint S, Whooley MA (Eds.) Current Essentials of Medicine (4th ed.). New York: McGraw-Hill, 2011.
  4. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
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