Skip to main content

Erworbener Nystagmus und sakkadische Intrusionen

  • Living reference work entry
  • First Online:
Die Augenheilkunde

Part of the book series: Springer Reference Medizin ((SRM))

  • 80 Accesses

Zusammenfassung

Bei einem Nystagmus handelt es sich um periodische, meist unwillkürliche Augenbewegungen mit einer meist langsamen Augendrift und einer schnellen Rückstellphase. Leitsymptome können verschwommen Sehen, reduzierter Visus, Schwank-, Drehschwindel und/oder Gangstörungen sein. Die Diagnose beruht auf der Beschreibung von Form, Richtung (die nach der schnellen Phase angegeben wird) sowie auslösenden/modulierenden Faktoren. Häufige Formen sind peripherer oder zentraler Spontannystagmus sowie Blickrichtungs-, Lagerungs-, Kopfschüttel- und Rebound-Nystagmus; daneben gibt es Nystagmus-ähnliche Formen, wie Sakkadische Intrusionen. Ein Spontannystagmus ist definiert als ein in Primärposition ohne Provokationsmanöver vorhandener Nystagmus. Es kann sich um einen peripheren vestibulären Spontannystagmus, z. B. bei akuter unilateraler Vestibulopathie, oder zentrale Formen wie Downbeat- oder Upbeat-Nystagmus handeln. Therapie bei den beiden letzteren ist 4-Aminopyridin.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Similar content being viewed by others

Literatur

  • Bense S, Best C, Buchholz HG et al (2006) 18F-fluorodeoxyglucose hypometabolism in cerebellar tonsil and flocculus in downbeat nystagmus. Neuroreport 17(6):599–603

    Article  PubMed  Google Scholar 

  • Brandt T, Dieterich M, Strupp M (2003) Vertigo – Leitsymptom Schwindel. Steinkopff, Darmstadt

    Google Scholar 

  • Buttner U, Brandt T, Helmchen C (2000) The direction of nystagmus is important for the diagnosis of central paroxysmal positioning nystagmus (cPPV). Neuro-Ophthalmology 21(2):97–104

    Article  Google Scholar 

  • Claassen J, Spiegel R, Kalla R et al. (2013) A randomised double-blind, cross-over trial of 4-aminopyridine for downbeat nystagmus–effects on slowphase eye velocity, postural stability, locomotion and symptoms. J Neurol Neurosurg Psychiatry 84:1392–1399

    Google Scholar 

  • Eggers SDZ, Bisdorff A, von Brevern M et al (2019) Classification of vestibular signs and examination techniques: nystagmus and nystagmus-like movements. J Vestib Res 29(2–3):57–87

    Google Scholar 

  • Etzion Y, Grossman Y (2001) Highly 4-aminopyridine sensitive delayed rectifier current modulates the excitability of guinea pig cerebellar Purkinje cells. Exp Brain Res 139(4):419–425

    Article  CAS  PubMed  Google Scholar 

  • Feil K, Claassen J, Bardins S et al (2013) Effect of chlorzoxazone in patients with downbeat nystagmus: a pilot trial. Neurology 81(13):1152–1158

    Article  CAS  PubMed  Google Scholar 

  • Feil K, Strobl R, Schindler A et al (2019) What is behind cerebellar vertigo and dizziness? Cerebellum 18(3):320–332

    Article  CAS  PubMed  Google Scholar 

  • Glasauer S, Kalla R, Buttner U et al (2005) 4-aminopyridine restores visual ocular motor function in upbeat nystagmus. J Neurol Neurosurg Psychiatry 76(3):451–453

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Halmagyi GM, McGarvie LA, Strupp M (2020) Nystagmus goggles: how to use them, what you find and what it means. Pract Neurol 20(6):446–450

    Article  PubMed  Google Scholar 

  • Helmchen C, Sprenger A, Rambold H et al (2004) Effect of 3,4-diaminopyridine on the gravity dependence of ocular drift in downbeat nystagmus. Neurology 63(4):752–753

    Article  CAS  PubMed  Google Scholar 

  • Hufner K, Frenzel C, Kremmyda O et al (2015) Esophoria or esotropia in adulthood: a sign of cerebellar dysfunction? J Neurol 262(3):585–592

    Article  PubMed  Google Scholar 

  • Kalla R, Deutschlander A, Hufner K et al (2006) Detection of floccular hypometabolism in downbeat nystagmus by fMRI. Neurology 66(2):281–283

    Article  CAS  PubMed  Google Scholar 

  • Kalla R, Glasauer S, Buttner U et al (2007) 4-aminopyridine restores vertical and horizontal neural integrator function in downbeat nystagmus. Brain 130(Pt 9):2441–2451

    Google Scholar 

  • Kremmyda O, Feil K, Bardins S et al (2023) Acetyl-DL-leucine in combination with memantine improves acquired pendular nystagmus caused by multiple sclerosis: a case report. J Neurol 270:4107–4109

    Google Scholar 

  • Leigh RJ, Zee D (2015) The neurology of eye movements, 5. Aufl. Oxford University Press, Oxford/New York

    Google Scholar 

  • Lemos J, Strupp M (2022) Central positional nystagmus: an update. J Neurol 269:1851–1860

    Google Scholar 

  • Mantokoudis G, Wyss T, Zamaro E et al (2021) Stroke prediction based on the spontaneous nystagmus suppression test in dizzy patients: a diagnostic accuracy study. Neurology 97:e42–e51

    Google Scholar 

  • McClure JA (1985) Horizontal canal BPV. J Otolaryngol 14:30–35

    CAS  PubMed  Google Scholar 

  • Shaikh AG, Hong S, Liao K et al (2010) Oculopalatal tremor explained by a model of inferior olivary hypertrophy and cerebellar plasticity. Brain 133(Pt 3):923–940

    Article  PubMed  PubMed Central  Google Scholar 

  • Sprenger A, Zils E, Rambold H et al (2005) Effect of 3,4-diaminopyridine on the postural control in patients with downbeat nystagmus. Auris Nasus Larynx 1039:395–403

    CAS  Google Scholar 

  • Strupp M (2018) Nystagmus – Schritt für Schritt. Neurologie up2date 1:17–21

    Article  Google Scholar 

  • Strupp M, Schuler O, Krafczyk S et al (2003) Treatment of downbeat nystagmus with 3,4-diaminopyridine: a placebo-controlled study. Neurology 61(2):165–170

    Article  CAS  PubMed  Google Scholar 

  • Strupp M, Thurtell MJ, Shaikh AG et al (2011a) Pharmacotherapy of vestibular and ocular motor disorders, including nystagmus. J Neurol 258(7):1207–1222

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Strupp M, Hufner K, Sandmann R et al (2011b) Central oculomotor disturbances and nystagmus: a window into the brainstem and cerebellum. Dtsch Arztebl Int 108(12):197–204

    PubMed  PubMed Central  Google Scholar 

  • Strupp M, Kremmyda O, Adamczyk C et al (2014a) Central ocular motor disorders, including gaze palsy and nystagmus. J Neurol 261(Suppl 2):S542–S558

    Article  PubMed  Google Scholar 

  • Strupp M, Fischer C, Hanss L et al (2014b) The takeaway Frenzel goggles: a Fresnel-based device. Neurology 83(14):1241–1245

    Article  PubMed  PubMed Central  Google Scholar 

  • Strupp M, Straumann D, Helmchen C (2021) Nystagmus: diagnosis, topographic anatomical localization and therapy. Klin Monatsbl Augenheilkd 238(11):1186–1195

    Article  PubMed  Google Scholar 

  • Strupp M, Brandt T, Dieterich M (2022) Vertigo – Leitsymptom Schwindel, 3. Aufl. Springer, Heidelberg

    Book  Google Scholar 

  • Wagner J, Lehnen N, Glasauer S et al (2009) Downbeat nystagmus caused by a paramedian ponto-medullary lesion. J Neurol 256:1572–1574

    Article  PubMed  Google Scholar 

  • Wagner JN, Glaser M, Brandt T et al (2008) Downbeat nystagmus: aetiology and comorbidity in 117 patients. J Neurol Neurosurg Psychiatry 79(6):672–677

    Article  CAS  PubMed  Google Scholar 

  • Zee DS, Friendlich AR, Robinson DA (1974) The mechanism of downbeat nystagmus. Arch Neurol 30(3):227–237

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael Strupp .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Strupp, M., Straumann, D., Helmchen, C. (2023). Erworbener Nystagmus und sakkadische Intrusionen. In: Pfeiffer, N., Cursiefen, C., Holz, F.G., Lagrèze, W.A. (eds) Die Augenheilkunde. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-65929-8_87-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-65929-8_87-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-65929-8

  • Online ISBN: 978-3-662-65929-8

  • eBook Packages: Springer Referenz Medizin

Publish with us

Policies and ethics