Nystagmus is a vision condition in which the eyes make repetitive, uncontrolled movement which results in visual impairment. These movements often result in reduced vision and depth perception and can affect balance and coordination. There are several form of nystagmus however the form associated with multiple sclerosis is called “Aquired Nystagmus”. These involuntary eye movements can occur from side to side, up and down, or in a circular pattern. As a result, both eyes are unable to steadily view objects. People with nystagmus might nod and hold their heads in unusual positions to attempt compensate for the condition.
It has been estimated that some 80% of multiple sclerosis (MS) patients experience eye complications related to the disease. Complications including nystagmus, diplopia, internuclear ophthalmoplegia and optic neuritis. Complete vision loss is rare with multiple sclerosis but can occur. Its is always best to speak with your health care professionals about these conditions and the risks associated with them. Often prescription medications can lessen the possibility of severe eyesight problems or potential blindness.
Nystagmus is common in MS, it is estimated to occurr in approximately 30% of patients.
Nystagmus often exhibits itself for between six and eight weeks time. People with more progressive forms of multiple sclerosis however may have a persistent and lifelong debilitation of eyesight due to the condition.
The symptom is related to the complex optical network in the Central Nervous System (CNS) required for both eyes to hold a gaze. In more severe cases of nystagmus when looking straight ahead the eyes may have a upward or downward beating, a pendulum type effect or up and down oscillations. These forms of nystagmus symptoms are often indicative of the location of the brain which has suffered a lesion due to an MS attack (exacerbation).
Many people with MS who have mild nystagmus don’t realise they have it, as the movement has little or no effect on their vision. It’s often something doctors will pick up on when they’re testing eye movements. However, some people do notice a significant effect on their vision. Objects may seem to move back and forth, to jerk or to wiggle. This is known as oscillopsia.
As with other MS-related eye problems, visual problems caused by nystagmus can vary. For example, some people notice their vision can get worse when they are stressed, tired or hot.
Types of Nystagmus Associated With MS:
A variety of other types of nystagmus and nystagmoid eye movements have been reported in patients with MS including but not limited to these below:
See-saw nystagmus occurs with one eye moving up while the other moves downwards in a see-saw type of motion.
Head-shaking nystagmus is a latent spontaneous vestibular nystagmus. It is provoked in a seated patient by rapid passive head shaking.
Periodic alternating nystagmus is a strictly horizontal nystagmus that predictably oscillates in direction, amplitude, and frequency. For instance, a rightward beating nystagmus develops progressively larger amplitudes and higher frequencies up to a certain point, then wanes, eventually leading to a short period of downbeat or no nystagmus. Then, the nystagmus reverses direction, with a crescendo–decrescendo pattern that again leads to a short period without nystagmus, to complete the cycle. PAN may be congenital or acquired.
Several other forms of nystagmus have been associated with MS.
What Causes Nystagmus?
Nystagmus is most commonly caused by a neurological problem that is present at birth or develops in early childhood. Acquired nystagmus, which occurs later in life, can be the symptom of another condition or disease, such as stroke, multiple sclerosis or trauma.
Other causes of nystagmus include:
- Lack of development of normal eye movement control early in life
- Very high refractive error, for example, nearsightedness (myopia) or astigmatism
- Congenital cataracts
- Inflammation of the inner ear
- Medications such as anti-epilepsy drugs
- Central nervous system diseases
Several drugs including gabapentin, memantine, baclofen, and clonazepam can be helpful for visually disabling nystagmus.
In severe cases of nystagmus eye muscle surgical procedures can help with the condition or paralyzing eye muscles with botulinum toxin can help alleviate the condition.
There is a considerable amount or research in progress in respect to this condition which also occurs in other disorders such as stroke, alcoholism and more.
There are essentially no natural forms of remedies known that cure nystagmus however to help with the condition, good lighting, large reading materials and often finding a position of the head where it seems subside some have been reported to be helpful by people who experience nystagmus. Further some people with the condition have stated that Chromium Picolinate and Bilberry extract can help mitigate the symptom to some extent. As with any attempt to cope with a MS symptom it is important to contact your healthcare professionals and get their approval prior to modifying anything to do with multiple sclerosis or its symptoms.