Diagnosis and Management of Congenital Periodic Alternating Nystagmus.
- Author:
Ik Hee RYU
1
;
Yoon Hee CHANG
;
Jee Ho CHANG
;
Jong Bok LEE
Author Information
1. The Institute of Vision Research, Department of Ophthalmology, Yonsei University college of medicine, Seoul, Korea. 491209@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Electrooculography;
Four rectus muscle recession;
Kestenbaum-Anderson procedure;
Periodic alternating nystagmus
- MeSH:
Child;
Diagnosis*;
Electrooculography;
Eye Movements;
Head;
Humans;
Nystagmus, Pathologic*;
Posture;
Retrospective Studies;
Visual Acuity
- From:Journal of the Korean Ophthalmological Society
2005;46(9):1540-1546
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To investigate clinical findings, diagnostic criteria and management for patients with congenital periodic alternating nystagmus (PAN). METHODS: A retrospective analysis of clinical findings and electrooculography (EOG) of patients with congenital PAN was performed. Thirteen patients diagnosed with congenital PAN from March 1992 to December 2002 were included. RESULTS: Of 13 patients, the median age at initial visit was 7 years old (range: 1 to 30 years). Eight patients had abnormal head posture. The mean value for the period of alteration was 265.7 seconds. Six patients who received either the modified Kestenbaum-Anderson procedure or four rectus muscle recession showed a significant decrease in amplitude and/or frequency of nystagmus, and showed statistically significant improvement in visual acuity in LogMAR after the procedures by 0.33+/-0.09 in right eye, 0.34+/-0.11 in the left eye, compared with preoperative acuities of 0.43+/-0.19 and 0.38+/-0.09 respectively. CONCLUSIONS: Congenital PAN requires the evaluation of nystagmus along with a thorough evaluation of eye movement and EOG. Close follow is necessary to evaluate the pattern of nystagmus. Also, either modified Kestenbaum-Anderson procedure or four rectus muscle recession could be effective, depending on the presence of abnormal head posture.
