June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Spasmus nutans often reveals an underlying, potentially severe, disease.
Author Affiliations & Notes
  • Gilles Martin
    Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
  • Alexandra Gavard-Perret
    Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
  • Olivia Zambrowski
    Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
  • Isabelle Ingster-Moati
    Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
  • Nathalie Boddaert
    Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
  • Pierre-Paul Vidal
    COGNAC-G, Université Paris-Descartes, Sorbonne Paris Cité, Paris, France
  • Matthieu Robert
    Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
    COGNAC-G, Université Paris-Descartes, Sorbonne Paris Cité, Paris, France
  • Footnotes
    Commercial Relationships Gilles Martin, None; Alexandra Gavard-Perret, None; Olivia Zambrowski, None; Isabelle Ingster-Moati, None; Nathalie Boddaert, None; Pierre-Paul Vidal, None; Matthieu Robert, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5214. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Gilles Martin, Alexandra Gavard-Perret, Olivia Zambrowski, Isabelle Ingster-Moati, Nathalie Boddaert, Pierre-Paul Vidal, Matthieu Robert; Spasmus nutans often reveals an underlying, potentially severe, disease.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5214.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: Spasmus nutans is a type of nystagmus that has been known for years to be benign, while recent studies have shown that it sometimes reveals serious neurological or retinal disease. We tested the hypothesis that spasmus nutans is most often not benign and idiopathic. We performed a retrospective, observational study to better understand the conditions associated with spasmus nutans-type nystagmus, as well as the incidence of these conditions.

Methods: Children referred to the neuro-ophthalmology clinic between November 1, 2009 and November 1, 2014, for a spasmus nutans and having benefitted from a systematic work-up were retrospectively reviewed. Spasmus nutans was defined as a pendular nystagmus with a high beating frequency (>5Hz), a small amplitude and a phase dissociation between the two eyes. It could be intermittent, horizontal, vertical, torsional or multidirectional and dissociated to the extent of being purely monocular. It could be associated with head tilt or head nodding. The work-up included neuro-ophthalmological examination with dilated fundus, recording of the nystagmus (video, eye tracking with a child-friendly dedicated infrared photo-reflectometry eye tracker, Ober Consulting®, Poland, when possible) cerebral imaging (MRI-scan) and electroretinography (Metrovision®, France). Cases with incomplete investigations, cases with already known diagnosis and also incidentally presenting a spasmus nutans and cases with obvious associated photophobia at the first visit were excluded. The combination of these data allowed us to classify each case in one of three groups of categories of spasmus nutans (revealing a neurological disease, revealing a retinal disease, or idiopathic) and to compare their relative proportions.

Results: Thirty-two children (19 males) were included. The nystagmus had been noticed at a median age of 5 months. In 53% of cases (n=17), it led to the diagnosis of another condition. Most often a neurological disease was diagnosed (34%, n=11) such as chiasmal gliomas (22%, n=7), while 13% (n=4) of the children exhibited a retinal dysfunction. In 47% (n=15) of cases, spasmus nutans was considered benign idiopathic.

Conclusions: In this study, spasmus nutans-type nystagmus was, in the majority of cases, the revealing symptom of another disease, often severe, and not a benign clinical entity. A systematic work-up should be considered in any case of a child who presents with spasmus nutans.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×