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Torsional nystagmus

Quantitative features and possible pathogenesis

From the Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada (Drs. Noseworthy and Ebers); and the Ocular Motor Neurophysiology Laboratory, VA Medical Center, and Department of Neurology, University Hospitals, Case Western Reserve University, Cleveland, OH (Drs. Leigh and Dell'Osso).

We measured eye rotations in three planes in a patient with acquired, torsional nystagmus. This nystagmus had linear or increasing-velocity waveforms, was increased after active pitch rotations of the head, and was suppressed by convergence. Magnetic resonance imaging demonstrated a midpontine lesion that was probably a venous angioma. We postulate that torsional nystagmus in this patient was due to disruption of central vestibular connections.

Address correspondence and reprint requests to Dr. Leigh, Department of Neurology, University Hospitals of Cleveland, 2074 Abington Road, Cleveland, OH 44106.

Supported by a Career Development Award from the Multiple Sclerosis Society of Canada (to Dr. Noseworthy), a Career Scientist Award from the Ontario Ministry of Health (to Dr. Ebers), US PHS grant EY06717 (to Dr. Leigh), the Evenor Armington Fund, and the Veterans Administration.

Received August 27, 1987. Accepted for publication in final form October 26, 1987.

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