- Journal of Pediatric Ophthalmology and Strabismus
- July/August 2012 - Volume 49 · Issue 4: 242-246
To assess the incidence of intracranial pathology in young children who had brain magnetic resonance imaging (MRI) to investigate apparently isolated nystagmus noted within the first few years of life.
Retrospective institutional review of such children (up to 5 years old).
Twenty-six patients (17 boys, 9 girls) were identified. Nystagmus was clinically bilateral in 22 (85%) and unilateral in 4 (15%). Seventeen cases (65%) were described as horizontal pendular nystagmus, 5 (19%) as horizontal jerk nystagmus, 2 (8%) as vertical pendular nystagmus, and 1 each as downbeat nystagmus and torsional nystagmus (8%). Three of the 26 patients (12%) had significant MRI findings and all three had temporal optic nerve head pallor noted during clinical examination. Nystagmus was horizontal pendular in two patients and rotary in the third.
The optic nerve head should be carefully assessed for signs of pallor in young children with nystagmus and, if present, brain MRI should be performed. Otherwise, isolated early childhood nystagmus is unlikely to be associated with intracranial pathology. Clinical description of nystagmus did not predict intracranial pathology in this cohort.
From King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Arif O. Khan, MD, King Khaled Eye Specialist Hospital, P. O. Box 7191, Riyadh 11462, Saudi Arabia. E-mail: firstname.lastname@example.org