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A CASE OF EPILEPTIC NYSTAGMUS Hideaki Enokido 1 , Yuzuru Sano 1 , Yoshifumi Koshino 1 , Nariyoshi Yamaguchi 2 1Department of Neuropsychiatry, Kanazawa Medical University 2Department of Neuro-Psychiatry, Kanazawa University School of Medicine. pp.1277-1283
Published Date 1977/12/1
DOI https://doi.org/10.11477/mf.1406204167
  • Abstract
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A case of isolated epileptic nystagmus was re-ported.

Case : M. Y. A 18-year-old female. She was free from any diseases which might provoke the con-vulsive disorder in her early history. When 15-year-old, she began to see that the objects had oscillated abruptly in her sight. During this attack, no motor activity was recognized and her consciousness was clear. Neurologically, she has no pathologic sign except for the occasional fine ocular movement at rest. Brain scanning, CAG, VAG and CSF are not remarkable.

Interictal EEG : single big spikes are numerous over the left post-temporal area. Occasionally, the EEG focus migrates to the left central area or to the frotalpole from the left post-temporal area.

Clinical seizure : she experiences oscillopsia sub-jectively during her seizure and objectively jerking nystagmus to the right and pendular nystagmus are obserbed but no conjugate deviation and head deviation.

fetal EEG : Initially, burst of poly spikes occured in the post-temporal and occipital area is followed by the so-called "electrically silent phase" in which the EEG activities are depressed and spike dis-charges disappear, but during this phase, the seizure nystagmus starts. Secondly, low voltage rhythmic seizure discharges of β band appear and, gradually, their amplitude increase and alter to the a band's rhythmic wave. The seizure, finally, terminates in the form of continuous rhythmic spikes.

Therapy : Carbamazepine was used 400 mg/day. Number of clinical seizures decreased and, electro-encephalographically, the single spikes decreased remarkably in their frequency and amplitude. The drug was effective.

The authors concluded that epileptic nystagmus of this case might be originated from the occipital eye field (Area 19, 18, 17) and also suspected that the oculomotor system, involved the frontal eye field (Area 8), might be unstable to the epileptic changes.


Copyright © 1977, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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