Journal of the Korean Ophthalmological Society 2005;46(9):1540-1546.
Published online September 30, 2005.
Diagnosis and Management of Congenital Periodic Alternating Nystagmus.
Ik Hee Ryu, Yoon Hee Chang, Jee Ho Chang, Jong Bok Lee
1The Institute of Vision Research, Department of Ophthalmology, Yonsei University college of medicine, Seoul, Korea. 491209@yumc.yonsei.ac.kr
2Department of Ophthalmology, Ajou University college of medicine, Suwon, Korea.
선천주기교대눈떨림의 임상적 양상
류익희1,장윤희2,장지호1,이종복1
The Institute of Vision Research, Department of Ophthalmology, Yonsei University college of medicine1, Seoul, Korea Department of Ophthalmology, Ajou University college of medicine2, Suwon, Korea
Correspondence:  Ik-Hee Ryu, M.D.1
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.
Key Words: Electrooculography;Four rectus muscle recession;Kestenbaum-Anderson procedure;Periodic alternating nystagmus


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