Clin Exp Otorhinolaryngol.  2013 Dec;6(4):259-262.

Epileptic Nystagmus and Vertigo Associated with Bilateral Temporal and Frontal Lobe Epilepsy

• Kim KS
• Kim YH
• Hwang Y
• Kang B
• Kim DH
• Kwon YS

Abstract

Epileptic nystagmus is defined as a quick, repetitive jerky movement of the eyeball associated with seizure activity. In cases of epileptic nystagmus associated with ictal discharge from multiple brain areas, localization of the exact epileptogenic zone could be extremely difficult. In a nine-year-old patient with epileptic nystagmus and vertigo associated with bilateral temporal and frontal lobe epilepsy, we could infer the epileptic focus by interpreting the patient's clinical picture, characteristics of nystagmus, and findings of electroencephalography.

Keyword

Epilepsy; Pathologic nystagmus; Vertigo; Electroencephalography

MeSH Terms

Brain
Electroencephalography
Epilepsy
Epilepsy, Frontal Lobe*
Frontal Lobe*
Humans
Nystagmus, Pathologic
Seizures
Vertigo*

Figure

• 

  Fig. 1 Ictal electroencephalography shows (A) initial rhythmic fast spikes with discharges in the right temporal area (arrow) during the onset of nystagmus and vertigo and (B) continued rhythmic fast spikes in bilateral temporal regions (arrow). Which were followed by (C) rhythmic fast frequency spikes in the bilateral frontal area (arrow). Fp, frontopolar; F, frontal; C, cental; T, temporal; P, parietal; O, occipital; Even number, right; Odd number, left.

Reference

1. Bajwa R, Jay WM, Asconape J. Neuro-ophthalmologic manifestations of epilepsy. Semin Ophthalmol. 2006; Oct-Dec. 21(4):255–261. PMID: 17182413.

2. Nicita F, Papetti L, Spalice A, Ursitti F, Massa R, Properzi E, et al. Epileptic nystagmus: description of a pediatric case with EEG correlation and SPECT findings. J Neurol Sci. 2010; 11. 298(1-2):127–131. PMID: 20832824.

3. Kellinghaus C, Skidmore C, Loddenkemper T. Lateralizing value of epileptic nystagmus. Epilepsy Behav. 2008; 11. 13(4):700–702. PMID: 18707021.

4. Bower CM, Cotton RT. The spectrum of vertigo in children. Arch Otolaryngol Head Neck Surg. 1995; 8. 121(8):911–915. PMID: 7619420.

5. Weber YG, Roesche J, Lerche H. Epileptic nystagmus: two case reports, clinical and pathophysiological review of the literature. J Neurol. 2006; 6. 253(6):767–771. PMID: 16511649.

6. Kogeorgos J, Scott DF, Swash M. Epileptic dizziness. Br Med J (Clin Res Ed). 1981; 2. 282(6265):687–689.

7. Bense S, Stephan T, Yousry TA, Brandt T, Dieterich M. Multisensory cortical signal increases and decreases during vestibular galvanic stimulation (fMRI). J Neurophysiol. 2001; 2. 85(2):886–899. PMID: 11160520.

8. Kaplan PW, Tusa RJ. Neurophysiologic and clinical correlations of epileptic nystagmus. Neurology. 1993; 12. 43(12):2508–2514. PMID: 8255448.

9. Stolz SE, Chatrian GE, Spence AM. Epileptic nystagmus. Epilepsia. 1991; 12. 32(6):910–918. PMID: 1743165.

10. Harris CM, Boyd S, Chong K, Harkness W, Neville BG. Epileptic nystagmus in infancy. J Neurol Sci. 1997; 10. 151(1):111–114. PMID: 9335021.

11. Plochl M, Ossandon JP, Konig P. Combining EEG and eye tracking: identification, characterization, and correction of eye movement artifacts in electroencephalographic data. Front Hum Neurosci. 2012; 10. 6:278. PMID: 23087632.