Pendular seesaw nystagmus in a patient with a giant pituitary macroadenoma: Pathophysiology and the role of the accessory optic system

Peter Yat Ming Woo, Saori Takemura, Allen Ming Yan Cheong, Alberto Chi Ho Chu, Yung Chan, Hoi Tung Wong, Kwong Yau Chan

Research output: Journal article publicationJournal articleAcademic researchpeer-review

3 Citations (Scopus)

Abstract

Seesaw nystagmus is characterized by cyclic eye movements with a conjugate torsional component and a dissociated vertical component. In the first half of the cycle, one eye elevates and intorts, whereas the other eye depresses and extorts. The pattern is reversed in the remaining half of the cycle. We describe a patient with a giant pituitary adenoma who developed pendular seesaw nystagmus. Disturbance in the visuovestibular system is postulated to contribute to this form of seesaw nystagmus. Lesions compressing the optic chiasm and the accessory optic system could interrupt the transmission of retinal error signals to the inferior olivary nucleus and the interstitial nucleus of Cajal, thus interfering with the adaptive mechanism of the vestibulo-ocular reflex and leading to pendular seesaw nystagmus.

Original languageEnglish
Pages (from-to)65-69
Number of pages5
JournalJournal of Neuro-Ophthalmology
Volume38
Issue number1
DOIs
Publication statusPublished - 1 Mar 2018

ASJC Scopus subject areas

  • Ophthalmology
  • Clinical Neurology

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