Table of ContentsView AllTable of ContentsWhat Is Nystagmus?SymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
What Is Nystagmus?
Symptoms
Causes
Diagnosis
Treatment
Typically, nystagmus is detected during a physical examination that involves an eye evaluation. It may be an early sign of a neurological condition, such asmultiple sclerosis (MS), or it can develop as an already established neurological illness progresses. You may need treatment to help reduce your nystagmus and/or the accompanying effects.
In this article, we will explore the symptoms and causes of nystagmus, as well as how it is diagnosed and treated.
shaun / E+ / Getty Images
Nystagmus is a condition where the eyes move on their own, typically in quick, jerky movements. Nystagmus looks like a rapid, rhythmic, horizontal (side to side) motion in the eyes. Vertical (up and down) or rotary (moving in a circle) nystagmus can also occur, but these patterns are not typical.
Nystagmus typically affects both eyes, but it can rarely affect just one eye. The jerking movements are not usually present all the time, and nystagmus is often more noticeable when looking to one side or the other. In severe cases, eye jerking can be present all the time, even when looking straight ahead (not to the side).
Symptoms of Nystagmus
Common symptoms of adult-acquired nystagmus (which differs from congenital nystagmus) include:
You can experience all or some of these symptoms when you have nystagmus. However, when nystagmus is present for a long time, the symptoms are not evident.
If you have any signs of nystagmus, you need to get medical attention. The neurological issues that are commonly associated with eye jerking can progressively worsen if they are not treated.
Causes of Nystagmus
Nystagmus is a symptom of some neurological illnesses and conditions that involve the inner ear. Many neurological diseases can be associated with eye jerking. Some of the conditions that cause nystagmus are serious and life-threatening, such as a brain tumor. Others are not associated with serious health risks, such aslazy eye.
Common Risk Factors
The conditions that increase your risk of nystagmus do not always produce it. Nystagmus is a relatively uncommon sign of neurological or inner ear disease.
Twirling: Twirling around in a circle for a few minutes and then stopping can cause a brief period of nystagmus that affects both eyes. This is generally harmless, but you may feel dizzy for minutes or even the day afterward.
Strabismus (lazy eye): A congenital (from birth) difference may cause the eyes to be misaligned, causing a visibly obvious effect: a lazy eye. Sometimes, nystagmus can occur with a lazy eye, especially when you look to the extreme left or right.
Multiple sclerosis (MS): This condition can cause various neurological symptoms because it can affect different areas of thebrain,spinal cord, and/oroptic nerve(the nerve that controls vision). MS may cause permanent or intermittent episodes of nystagmus in one or both eyes.
Brain tumor: A primary brain tumor (a tumor that starts in the brain) or a metastatic cancer from elsewhere in the body can invade or impinge on thecranial nerves, brainstem, or cerebellum in a manner that causes nystagmus to develop.
Stroke: An interruption in blood flow in the brain can cause brain damage. In rare instances, a stroke can result in nystagmus.
Paraneoplastic syndrome: Several types of cancer can produce antibodies (immune cells) that attack a person’s own body, causing paraneoplastic syndrome, a rare cancer side effect. Nystagmus is one of the common symptoms of paraneoplastic syndromes. Ovarian cancers and adrenal cancers are examples of cancers that may have this effect.
Medications: Some medications can cause nystagmus as a side effect. Examples include Dilantin (phenytoin), Tegretol (carbamazepine), and barbiturates. These medications interfere with nerve function, and the nystagmus should wear off after the medication is metabolized from the body.
Alcohol: Alcohol intoxication can temporarily affect the nerves that control balance, resulting in coordination problems and nystagmus.
Trauma: A traumatic injury can cause damage to the brain, nerves, or muscles that control eye movement, resulting in nystagmus.
A few areas of the brain and inner ear are involved with coordinating eye movements. A permanent injury or temporary deficit involving any of these areas can interfere with regular eye movements, causing several potential vision and/or balance problems, including nystagmus.
Nystagmus can result from impairment of any of the following structures:
Brainstem: The cranial nerve fibers and the nerve fibers of the cerebellum run through the brainstem, an area of the brain that links the brain with the spinal cord. For this reason, a disease that involves the brainstem (such as bleeding or stroke) may cause nystagmus.
Inner ear: The inner ear contains many tiny structures that control hearing and help mediate balance. Inflammation, infections, and tumors involving the inner ear can cause nystagmus.
Diagnosing Nystagmus
Even if you have many associated symptoms, nystagmus is typically unnoticeable in day-to-day life. You are unlikely to notice your jerky eye movements. Seeing your nystagmus in the mirror is very difficult because the movements tend to be more intense when you look to the side. Sometimes, family or friends may notice your eyes jerking when they look at you.
During a medical examination, nystagmus is typically identified in a healthcare provider’s office. Your practitioner may check for nystagmus when doing a neurological examination during your yearly physical. Youreye muscles will be testedas you are asked to look toward each side with both eyes simultaneously and hold your gaze for a few seconds. Your eye doctor would also notice nystagmus during a routine eye examination (such as for your glasses or contact lenses).
If you have nystagmus, your medical team will do further tests to identify the cause and see whether you have any worrisome complications.
Diagnostic examinations you may need include:
Treating Nystagmus
Several treatments are used to help reduce the effects of nystagmus. Medications may be prescribed to decrease the eye-jerking movements. Sometimes, treatment is also needed to lessen the associated nausea and dizziness.
Additionally, if you have a neurological condition causing you to have nystagmus, you may need to use rehabilitative therapy for the management of your neurological disease.
Vision Correction
If a vision deficit is causing you to have nystagmus, you may need to use corrective lenses to help correct your vision. In some situations, surgical vision correction is considered the best option.
Control of Eye Jerking
Prescriptions used to diminish nystagmus include oral Firdapse (amifampridine), Lioresal (baclofen), Klonopin (clonazepam), and Neurontin (gabapentin).These medications may temporarily diminish your nystagmus but are not expected to cure it.
Symptomatic Therapies
If dizziness, nausea, and/or vomiting are problematic, your healthcare provider might recommend over-the-counter or prescription therapy to help alleviate these effects.
Medical Management of Neurological Disease
You may need to have medical therapy to treat the cause of your nystagmus. This can include disease-modifying therapy for the management of MS, anti-inflammatory medication to manage Ménière’s disease, or antibiotics to treat an inner ear infection.
Botox
Botulinum toxin weakens muscles, and when used for the treatment of nystagmus, it reduces the compensatory nystagmus that occurs when the eye muscles are not of equal strength.
How Botulinum Toxin Injection Is Used to Weaken Muscles
Surgery
In some situations, eye surgery can repair muscle defects causing nystagmus. You may need treatment for a brain tumor or an inner ear tumor. Treatment approaches for a tumor include surgical removal, radiation therapy, and/or chemotherapy.
Rehabilitation
Sometimes, therapy using rehabilitation techniques may be effective in strengthening eye muscles. If mild eye muscle weakness is the cause of your nystagmus, this can alleviate the problem.
Summary
Nystagmus is often a symptom of neurological disease. If your eye jerking is causing discomfort, you may need to have it treated.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Eggers SDZ.Approach to the examination and classification of nystagmus.J Neurol Phys Ther.2019;43 Suppl 2 Supplement, Special Supplement: International Conference on Vestibular Rehabilitation:S20-S26. doi:10.1097/NPT.0000000000000270
Kang S, Shaikh AG.Acquired pendular nystagmus.J Neurol Sci.2017;375:8-17. doi:10.1016/j.jns.2017.01.033
Serra A, Chisari CG, Matta M.Eye movement abnormalities in multiple sclerosis: Pathogenesis, modeling, and treatment.Front Neurol. 2018;9:31. doi:10.3389/fneur.2018.00031
Kruijt CC, De wit GC, Bergen AA, Florijn RJ, Schalij-delfos NE, Van genderen MM.The phenotypic spectrum of albinism.Ophthalmology.2018;125(12):1953-1960. doi:10.1016/j.ophtha.2018.08.003
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
